[Effect of lamivudine for hepatitis B virus reactivation in blood cancer patients undergoing immunosuppressive chemotherapy].
Immunosuppressants are often used in the treatment of cancer. Several recent studies have shown hepatitis B virus (HBV) reactivation after immunosuppressive chemotherapy in HB surface antigen (HBsAg)-negative patients who were positive for antibody to HB core antigen (anti-HBc) and/or antibody to HBsAg (anti-HBs). This study reports the medical course of 11 patients with blood cancer who underwent chemotherapy. All patients had at least one positive HBV marker (HBsAg, anti-HBs, anti-HBc). Before immunosuppressive chemotherapy, 5 patients were treated with lamivudine and 6 had no antiviral drug treatment. None of the lamivudine treated patients had HBV reactivation, but HBV was reactivated in all of the patients not treated with this antiviral drug, one of whom had severe exacerbation of liver function and died due to hepatic failure. Because lamivudine treatment was effective in preventing HBV reactivation in patients receiving immunosuppressive chemotherapy, HBsAg-negative patients with anti-HBs and/or anti-HBc need the antiviral medicines before immunosuppressive therapy.
Sugimoto
Rie
R
Department of Internal Medicine, National Kyusyu Cancer Center.
Enjoji
Munechika
M
Kotoh
Kazuhiro
K
Noguchi
Ken-ichi
K
Tsuruta
Satoru
S
Nakamuta
Makoto
M
Nawata
Hajime
H
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000494:pharmacology; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy*; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control* / Q000821:virology; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D019259:Lamivudine / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D014775:Virus Activation / Q000187:drug effects
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D019259:Lamivudine