- Screen all patients prior to starting systemic anticancer therapy with three tests: hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc, total Ig or IgG), and antibody to hepatitis B surface antigen (anti-HBs).
- Patients with positive HBsAg or positive anti-HBc may require additional monitoring and/or antiviral treatment.
- All patients with cancer anticipating systemic anticancer therapy should be tested for HBV by three tests prior to, or at the beginning of, systemic anticancer therapy:
- hepatitis B surface antigen (HBsAg)
- hepatitis B core antibody (anti-HBc) total immunoglobulin (Ig) or IgG
- antibody to hepatitis B surface antigen (anti-HBs)
Note: Anticancer therapy should not be delayed for the results of these screening tests. Findings of chronic HBV (HBsAg-positive) or past HBV (HBsAg-negative and anti-HBc-positive with either negative or positive anti-HBs) infection require reactivation risk assessment. (Strong Recommendation; EB-B)