Ibrutinib and Hepatitis B

[Dianaaaaaaaa]

Hello, my 72yo dad was recently diagnosed and he’s supposed to start treatment with Ibrutinib today. He had HepB as a child and I know that is a major red flag. The doctor is not very transparent about the risks and we’re freaking out. Does anyone have experience and suggestions with this? Also what other medications did you take with Ibrutinib like antibiotics etc and what were the side effects of Ibrutinib. Thanks!

[mrsjsmith]

Diana,

Just getting up and can give a fuller answer later but when I started Ibrutinib I was tested for Hepatitis and HIV before starting, it should be part of the protocol. Have you contact details for his CNS to check.

Colette

[Dianaaaaaaaa in reply to mrsjsmith]

Thanks! My dad was tested and he has the antibodies so he had it as a child. Having had it is a major red flag on the medication’s prospect so I’m interested in anyone with Hep B antibodies took it and what extra measures they took

[mrsjsmith in reply to Dianaaaaaaaa]

It’s down under a list of warnings and precautions and says talk to your doctor, pharmacist or nurse. I find my hospital pharmacist always helpful. Haematology should have their own. Your father should have monthly full blood tests when he starts Ibrutinib. Hope that helps.

Colette

[mantana]

Ibrutinib (or any other "CLL therapy") may re-awaken hepatitis B virus (HBV), which may still lay dormant in some liver cells - even if he produces antibodies and does not show HBsAg.

Your dad should be given an antiviral (tenofovir or entecavir) and he should be fine!

ashpublications.org/blood/a...

Here, a case of hepatitis B reactivation in a patient producing HBsAb (antibodies) without HBsAg (HBs antigen):

ncbi.nlm.nih.gov/pmc/articl...

Hepatitis B reactivation warning is mentioned in Ibrutinib prescribing information: rxabbvie.com/pdf/imbruvica_...

[ttomo]

Yes, he definitely needs to take an antiviral throughout treatment or be monitored regularly by a hepatologist. Most doctors recommend the antiviral regimen.

[mrsjsmith]

Diana,

A recent post by Kwenda about infections with patients with CLL mentions HepB. I only skip read but it’s worth you having a look at.

Colette

[Tirawa]

They need to do a hepatitis B test to see if there's any activity as well as antibody test to see if there's still antibodies. I had happy 40 years ago when I was in my early twenties and while there's no detectable hepatitis B in me I still test high on antibodies so I am currently taking meds so that it does not flare up potentially. Because if it flares up it could kill you

[Eirinik]

Hello Diana

I just saw your post my mother found out she had gone through hep b younger so the doctor told us to start taking ENTECAVIR 0,5 mg everyday in the morning on an empty stomach because she said treatments like this can flair it up but I guess each case is different I would advise to maybe talk to your doctor again and see what he says

[Jacksc06]

Hi I was treated for Hepatitus C with the abbieVie protocol in 2016. I have been taking IB since 2019. Not a medic so I don't know what the difference is between B & C. Hope this helps.