Abstract: Objective To investigate the risk factors of hepatitis B virus reactivation (HBVr) in HBsAg positive or anti-HBc positive chronic hepatitis B (CHB) patients after treated with immunosuppressants or chemotherapy drugs.Methods HBsAg positive CHB patients and HBsAg negative but anti-HBc positive CHB patients who received immunosuppressive therapy were retrospectively analyzed, the number of the patients was 238. According to the follow-up results, they were divided into HBVr group and non-HBVr group.The risk factors of HBVr were analyzed.Results The average age of 238 patients was 49 ± 14 years old, including 134 males (36.3%) and 33 HBVr patients (13.87%). Logistic regression model showed that there were significant differences between the two groups in whether received antiviral therapy (OR=0.022,95%Cl: 0.001～0.34), (P<0.001), baseline level of HBV DNA (OR=15.352,95%Cl:3.809～86.160), (P<0.001) and chemotherapy regimen (OR=0.361,95%Cl:0.068～1.929), (P=0.023), which were independent risk factors of HBVr. According to the results of variable screening, the regression equation for predicting the risk of HBVr was established as follows: -4.78×antiviral intervention (yes=1, no=0)+2.731×HBV DNA (≥104=1, <104=0)+3.272×chemotherapy regimen (A=3, B=2, C=1)+3.355, and the corresponding scoring system was also established.Conclusion HBVr is related to whether patients received antiviral therapy, the baseline level of HBV DNA and the choice of chemotherapy regimen. The new model will be helpful in predicting the risk of HBVr.

Key words: Hepatitis B virus reactivation, Immunosuppression, Prognosis, Risk factors