Impact of immunosuppression and chemotherapy on reactivation of viral hepatitis.
Chemotherapy drugs, biological medications that are used to treat cancer, may cause hepatic side effects. Patients with pre-existing viral hepatitis may be more susceptible to exacerbation of their underlying liver disease, and risk of drug-induced hepatotoxicity. We conducted a search on immunosuppression, and its impact on reactivation of viral hepatitis, using the electro-nic medical databases. Before starting chemotherapy, it is recommended to record the past history of liver disease and check for hepatitis B virus (HBV) and hepatitis C virus (HCV) serology. In immunosuppressed patients, radiation toxicity, graft versus host disease, hepatic veno-occlusive disease, acalculous cholecystitis, tumor infiltration, ischemia, other viruses such as CMV and her-pes virus, and systemic infection should also be considered. Transplant recipients with serologic evidence of previous infection with hepatitis B or C, or those who receive organs from a seropositive donor, should have viral load levels monitored before and after transplantation and, may also require treatment. We believe that there is a role for prophylactic use of antiviral treatment in patients at risk for HBV reactivation.
Fallahian
Farahnaz
F
Iran Research Center of Gastroenterology and Liver Disease, Firuzgar Hospital, Iran University of Medical Sciences, Tehran, Iran. falahianfff@yahoo.com
Alavian
Seyed-Moayed
SM
Fallahian
Vida
V
Zamani
Farhad
F
D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D016174:Hepacivirus / Q000502:physiology; D006506:Hepatitis A / Q000188:drug therapy* / Q000276:immunology; D006509:Hepatitis B / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000502:physiology; D006526:Hepatitis C / Q000188:drug therapy* / Q000276:immunology; D003698:Hepatitis Delta Virus / Q000502:physiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D019259:Lamivudine / Q000627:therapeutic use; D012008:Recurrence; D014775:Virus Activation / Q000276:immunology / Q000502:physiology
D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine