title: [Are the Japanese guidelines for the management of hepatitis B virus reactivation being properly implemented ?].
abstract: Hepatitis B virus(HBV)reactivation has been reported as a fatal complication following systemic chemotherapy or other immunosuppressive therapies. The Japanese Guidelines for HBV reactivation were published in 2009. Despite the publication of these guidelines, there have been some reports of fulminant hepatitis B. Therefore, it was suggested that the guidelines were not yet been widely implemented. We investigated whether the guidelines had been implemented in our hospital. After the evaluation, it was determined that 89%of HBV cases were screened for the HBV surface antigen(HBs-Ag). Additionally, the screening for HBV surface antibody(HBs-Ab)and HBV core antibody(HBc-Ab)should be performed in cases negative for HBs-Ag, which was performed in only 17% of HBs-Ag-negative cases. It was concluded that the guidelines had not been implemented in our hospital. Therefore, we conducted educational activities to promote the implementation of the guidelines. Screening tests were performed in all 270 HBV cases between January and June 2013. Two antigen-positive carriers were identified. The rate of HBs-Ag-negative and/or HBc antibody -positive cases was 20.3%. Of these, 76.4%were tested using a DNA quantitative test, but DNA quantification did not increase in any case. HBV reactivation is expected to increase due to the development of new drugs and the use of diverse regimens. All physicians who perform immunotherapy and chemotherapy should immediately participate in educational activities.
authors.affiliation: Dept. of Chemotherapy, Hoshigaoka Koseinenkin Hospital.
authors.forename: Aya
authors.initials: A
authors.lastname: Nakaya
authors.forename: Mina
authors.initials: M
authors.lastname: Hayashi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nitta
authors.forename: Takahito
authors.initials: T
authors.lastname: Nakamura
authors.forename: Takehiro
authors.initials: T
authors.lastname: Sando
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kamada
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Tatsumi
mesh_terms: D000914:Antibodies, Viral / Q000276:immunology; D000970:Antineoplastic Agents / Q000009:adverse effects*; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007564:Japan; D017410:Practice Guidelines as Topic; D014775:Virus Activation
chemical_list: D000914:Antibodies, Viral; D000970:Antineoplastic Agents; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents