免疫疗法显示出作为各种癌症治疗选择的前景。然而，关于免疫检查点阻断免疫疗法后乙型肝炎病毒（HBV）复活的潜在并发症越来越引起关注。虽然之前的大多数免疫检查点抑制剂（ICIs）的临床试验都不包括HBV患者，但已有一些关于HBV复活的个案报告和回顾性研究发布。本研究的目的是评估接受ICIs治疗的晚期癌症患者发生乙型肝炎病毒复活的风险（HBVr）。检索了2023年4月30日之前发表的英语和中文文献，包括PubMed、EMBASE、Web of Science、Cochrane、SinoMed、CNKI和万方数据库中报道ICIs治疗的癌症患者HBVr率的研究。根据数据从34个研究中检索并分析了7126名患者的数据。在接受ICIs治疗的癌症患者中，HBV复活率为1.3%（I2 = 90.44%，95% CI: 0.2-2.9%，P < 0.001）。亚组分析显示，被诊断为肝细胞肝癌（HCC）的患者、携带HBV的患者以及来自亚洲地区或发展中国家的患者HBV复活率较高。我们的荟萃分析结果表明，接受ICIs治疗的晚期癌症患者发生HBV复活的风险较低。对于现有HBV感染或慢性乙型肝炎患者，可以安全使用ICIs治疗，但需定期监测，并在需要时采取适当的抗病毒预防措施。© 2023.国家寄生虫病研究所。

Immunotherapy shows promise as a treatment option for various cancers. However, there is growing concern over potential complications from hepatitis B virus (HBV) reactivation after checkpoint blockade immunotherapy. Although most of the previous clinical trials on immune checkpoint inhibitors (ICIs) excluded patients with HBV, a few case reports and retrospective studies of HBV reactivation have been published. The aim of this study is to assess the risk of hepatitis B virus reactivation (HBVr) in patients receiving ICIs for advanced cancer.English and Chinese language literature published prior to April 30, 2023, was searched in PubMed, EMBASE, Web of Science, Cochrane, SinoMed, CNKI and Wanfang Data for studies reporting HBVr rates in cancer patients treated with ICIs. A pooled risk estimate was calculated for HBVr rates with 95% confidence intervals (CI).Data from 34 studies including 7126 patients were retrieved and analyzed. The pooled HBVr rate in cancer patients treated with ICIs was 1.3% (I2 = 90.44%, 95% CI: 0.2-2.9%, P < 0.001). Subgroup analysis revealed that patients diagnosed with hepatocellular carcinoma (HCC), HBV carriers, and patients from Asian regions or in developing countries have a higher rate of HBVr.Our meta-analysis demonstrated a low risk of HBVr in patients treated with ICIs for advanced cancer. ICI treatment may be safely used in patients with existing HBV infection or chronic hepatitis B, accompanied by regular monitoring and appropriate antiviral prophylaxis if necessary.© 2023. National Institute of Parasitic Diseases.