[Analysis of the prophylactic effect of nucleosides against reactivation of HBV in HBsAg-positive patients with non-hepatic tumors after chemotherapy].
OBJECTIVE
To investigate the efficacy of nucleosides as a prophylactic agent against reactivation of hepatitis B virus (HBV) in HBsAg-positive patients with non-hepatic tumors after chemotherapy.


METHODS
Fifty-eight patients with non-hepatic tumors were divided into prevention group and control group. The patients of prevention group received nucleosides as a prophylactic agent before chemotherapy and were compared with the control ones about the clinical manifestation of HBV reactivation. Then, the patients of the control group were divided into three groups according to antiviral drugs, use or not and time of the use. The patients having HBV reactivation but never received nucleosides were included in the group A, the patients receiving nucleosides after having HBV reactivation were divided into the group B, and the patients receiving nucleosides before HBV reactivation were divided into the group C. The progression, prognosis and curative effect among the three groups were compared.


RESULTS
The rate of HBV reactivation, incidence of severe hepatitis, mortality rate of the control group (61.1%, 27.8%, 16.7%) were significantly higher than those of the prevention group (13.6%, 0, 0), and liver dysfunction was more serious than that in the prevention group. In the control group, all the 5 patients of group A died of liver failure. Of the 13 patients in the group B, 4 cases suffered from severe hepatitis and 1 of them died of the disease. Of the 18 patients in the group C, 4 cases suffered from HBV reactivation, but the clinical manifestation was milder than that of the group B.


CONCLUSIONS
Nucleosides can be used as a prophylactic measure to prevent HBV reactivation. If chemotherapy had begun, the use of nucleosides may reduce the risk of HBV reactivation. Even if patients had suffered from HBV reactivation, the use of nucleosides may still help the recovery of liver function and improve prognosis.
Zhang
Hao-Ye
HY
Department of Infectious Diseases, The Third Xiangya Hospital of Central South University, Changsha 410013, China.
Liu
Zhen-Guo
ZG
Zhang
Zhen
Z
Gong
Huan-Yu
HY
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006509:Hepatitis B / Q000188:drug therapy / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000097:blood / Q000188:drug therapy; D008223:Lymphoma / Q000097:blood / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009705:Nucleosides / Q000627:therapeutic use; D011744:Pyrimidinones / Q000627:therapeutic use; D012189:Retrospective Studies; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives; D014775:Virus Activation / Q000187:drug effects*
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D009705:Nucleosides; D011744:Pyrimidinones; D000077712:Telbivudine; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; D013936:Thymidine