Gemcitabine and reactivation of hepatitis B.
Patients with chronic hepatitis B are at risk of reactivation of viral hepatitis during chemotherapy. We report a case of hepatitis B reactivation occurring in association with single-agent gemcitabine chemotherapy in the absence of significant myelosuppression. Gemcitabine is a nucleoside analog that can affect cell-mediated immunity, and this may contribute to an increased risk of reactivation of hepatitis B. We advise caution when administering chemotherapy to patients who are hepatitis B surface antigen positive, even when using relatively nontoxic palliative single-agent cytotoxic drugs. Monitoring of liver function tests will identify hepatitis, and measurement of hepatitis B DNA levels may help distinguish chemotherapy-induced hepatitis from hepatitis B virus reactivation.
Cheong
Kerry
K
Department of Medical Oncology, Flinders Medical Centre, Flinders Drive, Bedford Park SA 5042, Australia.
Li
Jordan
J
Karapetis
Christos Stelios
CS
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003841:Deoxycytidine / Q000009:adverse effects* / Q000031:analogs & derivatives*; D005260:Female; D006509:Hepatitis B / Q000139:chemically induced* / Q000201:enzymology; D006514:Hepatitis B Surface Antigens / Q000187:drug effects; D006801:Humans; D008111:Liver Function Tests; D010997:Pleural Neoplasms / Q000188:drug therapy*; D012008:Recurrence; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D006514:Hepatitis B Surface Antigens; D003841:Deoxycytidine; D000093542:Gemcitabine