Reactivation of hepatitis B but not hepatitis C in patients with malignant lymphoma and immunosuppressive therapy. A prospective study in 305 patients.
OBJECTIVE
The aim of this prospective study was to determine the prevalence of hepatitis B (HBV) and hepatitis C viral (HCV) infection as well as to study the morbidity and mortality of viral reactivations in patients treated with corticosteroid containing chemotherapy.


METHODS
From January 1991 to April 1996, 305 patients admitted for treatment of Hodgkin's disease and non-Hodgkin's lymphoma were tested for HBV, and 181 patients for HCV infection. They were followed-up regularly on a monthly basis with liver biochemistry and viral serology.


RESULTS
The prevalence of HBs antigen and hepatitis C antibody was found to be 3.2% and 16% respectively. There were 9 reactivations of HBV among 8 HBs antigen positive patients (78%), one among 35 HBs antigen negative patients (2.8%) and none in HCV positive patients. In 83% of cases, reactivation was connected to chemotherapy and corticosteroids. The overall death rate of HBV reactivation was 37%; in severe hepatitis it was 60%. All fatal reactivations were in anti-HBe positive patients.


CONCLUSIONS
The low prevalence of HCV failed to demonstrate an association between hepatitis C viral infection and lymphoma in Slovenia. Reactivation of HBV infection in HBsAg positive malignant lymphoma patients is a common and often fatal complication of treatment.
Markovic
S
S
Institute of Oncology, Ljubljana, Slovenia. smarkovic@onko-i.si
Drozina
G
G
Vovk
M
M
Fidler-Jenko
M
M
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D005260:Female; D016174:Hepacivirus / Q000187:drug effects* / Q000276:immunology; D006509:Hepatitis B / Q000139:chemically induced* / Q000276:immunology; D006515:Hepatitis B virus / Q000187:drug effects* / Q000276:immunology; D006526:Hepatitis C / Q000139:chemically induced* / Q000276:immunology; D006689:Hodgkin Disease / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008223:Lymphoma / Q000188:drug therapy* / Q000276:immunology; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000276:immunology; D012307:Risk Factors; D017524:Slovenia; D015996:Survival Rate; D014775:Virus Activation / Q000187:drug effects*
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents