title: Management of the HBV reactivation in isolated HBcAb positive patients affected with Non Hodgkin Lymphoma.
abstract: BACKGROUND
  Occult HBV infection (OBI) is defined by the persistence of HBV in the liver without serum HBsAg and HBVDNA. It represents a life-threatening event during immunosuppressive chemotherapies. An OBI occurs in approximately 18% of HBcAb + patients. International guidelines suggest surveillance for HBV markers in immunosuppressed patients. In Non-Hodgkin Lymphoma (NHL), the prevalence of OBI reactivation remains to be established.
  
  
  METHODS
  In order to determine the prevalence of occult HBV reactivation in a large cohort of patients during chemotherapy for NHL, we analysed 498 NHL patients in a centre of Southern Italy. We evaluated HBV markers, NHL type, treatment type and occurrence of HBV reactivation.
  
  
  RESULTS
  Forty % of patients were treated with monoclonal antibodies and 60.3% without. Ninety-six patients were HBcAb+, HBsAg-. HBV reactivation occurred in ten subjects of this subgroup. All of them were successfully treated with Lamivudine. None of the patients experienced liver-related death. The prevalence of OBI reactivation was of 10.42% in HBcAb + HBsAb- patients. This event occurred in 50% of patients treated with mild immunosuppressive therapies. Each reactivation was treated with Lamivudine.
  
  
  CONCLUSIONS
  This report suggests that a strict surveillance is important and cost-effective in HBcAb + HBsAg- NHL patients treated with mild immunosuppressive therapies, in order to detect an occult HBV reactivation.
authors.forename: Mario
authors.initials: M
authors.lastname: Masarone
authors.forename: Amalia
authors.initials: A
authors.lastname: De Renzo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: La Mura
authors.forename: Ferdinando Carlo
authors.initials: FC
authors.lastname: Sasso
authors.forename: Marco
authors.initials: M
authors.lastname: Romano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Signoriello
authors.forename: Valerio
authors.initials: V
authors.lastname: Rosato
authors.forename: Fabiana
authors.initials: F
authors.lastname: Perna
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pane
authors.affiliation: Internal Medicine and Hepatology Unit, University of Salerno, Via Allende, Baronissi (Salerno) CAP: 84081, Italy. mpersico@unisa.it.
authors.forename: Marcello
authors.initials: M
authors.lastname: Persico
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology / Q000502:physiology*; D006801:Humans; D019259:Lamivudine / Q000191:economics / Q000627:therapeutic use; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D000069283:Rituximab; D014750:Vincristine / Q000627:therapeutic use; D014775:Virus Activation
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone