Introduction:
This study aimed to evaluate the prophylactic antiviral therapy in low-risk patients with the Hepatitis B Virus (HBV) infections during chemotherapy.

Material and methods:
From January 2011 to March 2018, HBsAg-positive patients were analyzed in this retrospective study. The HBV reactivation, related hepatitis, chemotherapy delay, and fulminant hepatic failure in low-risk patients between the prophylactic anti-HBV therapy (prophylaxis group) and the non-prophylactic anti-HBV therapy group (control group) were compared.

Results:
There were 68 patients in the prophylaxis group and 102 patients in the control group. The results showed that the HBV reactivation was not significantly different between the prophylaxis group and the control group (p = 0.741). Three and 5 patients with HBV-related hepatitis were detected in the prophylaxis and control groups, respectively. Moreover, 2 and 4 patients with HBV activation-related chemotherapy delay were detected in the two groups, respectively, without any significant difference (p > 0.05). Multivariate analysis showed that HBV DNA titer was associated with HBV reactivation in low-risk patients (p = 0.001).

Conclusions:
Prophylactic antiviral therapy might not reduce the HBV reactivation of low-risk solid malignancies (non-HCC, non-hematological lymphatic cancer, and HBV DNA titer < 100 IU/ml). For low-risk patients, monitoring the HBV DNA titers and liver function tests in the follow-up observations might be an optimal and cost-effective strategy.