A prospective study on chemotherapy-induced hepatitis B virus reactivation in chronic HBs Ag carriers with hematologic malignancies and pre-emptive therapy with nucleoside analogues.
Chemotherapy-induced hepatitis B virus (HBV) reactivation is a serious problem in chronic HBV carriers with hematologic malignancies. In 12 patients with hematologic malignancies, we performed a prospective study to determine the effectiveness of nucleoside analogues in the pre-emptive therapy of chemotherapy-induced HBV reactivation. HBV reactivation occurred in seven patients (58.3%) whereas five of the seven patients (71%) responded to nucleoside analogue therapy. HBV reactivation-related acute liver failure and death was not observed in the present study. All five patients with chronic lymphocytic leukemia (CLL) experienced chemotherapy-induced HBV reactivation regardless of the chemotherapy regimen. Therefore, we suggest that CLL carries a significant risk of chemotherapy-induced HBV reactivation. The pre-emptive therapy of chemotherapy-induced HBV reactivation appears to be safe, based on the results of this pilot study. Pre-emptive therapy enables the definition of high-risk patients who cannot be identified by primary prophylaxis.
Yağci
Münci
M
Department of Haematology, Gazi Medical School, Ankara, Turkey. ayagci@gazi.edu.tr
Yağci
Müncý
M
Acar
Kadir
K
Acar
Kadýr
K
Sucak
Gülsan Türköz
GT
Aki
Zeynep
Z
Bozdayi
Gülendam
G
Haznedar
Rauf
R
D015075:2-Aminopurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000627:therapeutic use; D002908:Chronic Disease; D000077595:Famciclovir; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy; D006509:Hepatitis B / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009705:Nucleosides / Q000627:therapeutic use*; D010865:Pilot Projects; D011446:Prospective Studies; D014775:Virus Activation / Q000187:drug effects*
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D009705:Nucleosides; D019259:Lamivudine; D015075:2-Aminopurine; D000077595:Famciclovir