Reactivation of chronic hepatitis B infection following intensive chemotherapy and successful treatment with lamivudine: a case report and review of the literature.
BACKGROUND
Hepatitis B virus reactivation has been reported in cancer patients following administration of chemotherapy or immunosuppressive therapy and may result in liver damage of varying degrees of severity. Although treatment is supportive in nature, lamivudine, a nucleoside analogue has been found to suppress HBV replication as evidenced by reports of 13 cases in the medical literature.


METHODS
We report a patient who achieved a successful outcome with lamivudine following reactivation of HBV during combination chemotherapy for non-Hodgkin's lymphoma, and provide a brief overview of the literature including the 13 published case reports.


RESULTS
Lamivudine therapy resulted in clinical improvement as well as in normalization of liver function tests and coagulation profile.


CONCLUSIONS
Lamivudine has been found to suppress HBV replication manifested both by histology and serum HBV-DNA levels in chronic carriers of HBV who developed reactivation of hepatic disease following chemotherapy. Physicians caring for such patients should be able to recognize this clinical challenge, and lamivudine should be considered.
Saif
M W
MW
Medicine Branch, National Cancer Institute, National Naval Medical Center, Bethesda, Maryland 20889, USA. saifw@mail.nih.gov
Little
R F
RF
Hamilton
J M
JM
Allegra
C J
CJ
Wilson
W H
WH
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D006801:Humans; D016867:Immunocompromised Host; D019259:Lamivudine / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine