Effect of Antiviral Prophylaxis Strategy for Chemotherapy-Associated Hepatitis B Reactivation in Non-Hodgkin's Lymphoma Patients with Hepatitis B Virus Infection: A Retrospective Cohort Study.
Recent data indicates that nucleoside/nucleotide analogue (NUC) is effective in preventing and controlling hepatitis B virus (HBV) reactivation in HBV-carrying cancer patients who undergo chemotherapy, but the ideal antiviral agent and optimal application protocol still needs to be determined. Meanwhile, it is uncertain whether those with past HBV infection require antiviral prophylaxis during chemotherapy. This report retrospectively analyzed non-Hodgkin's lymphoma (NHL) patients seen from January, 2004 to June, 2009 in West China Hospital. We found that the prevalence of chronic HBV infection in our NHL patients was 20.7 % while that of past HBV infection was 21.05 %. Compared with the high rate (25.6 %) of HBV reactivation in patients with chronic HBV infection, none of those with past HBV infection in fact had occult HBV infection thus none experienced reactivation. Of the 82 patients with chronic HBV infection who received chemotherapy, antiviral prophylaxis could significantly reduce the incidence of HBV reactivation (5.0 vs. 45.2 % in the control group) and the incidence of liver function damage (32.5 vs. 73.8 % in the control group). The results of the current study confirmed previous reports that prophylactic NUCs administration can effectively prevent HBV reactivation and significantly reduce the incidence of HBV reactivation especially for patients receiving rituximab-containing regimens. Due to the fact that none of individuals who had past HBV infection developed HBV reactivation reported in our study, antiviral prophylaxis may not be required for patients with past HBV infection. Close observation of alanine aminotransferase and HBV-DNA contributes to early diagnosis and timely treatment of HBV reactivation.
West China School of Clinical Medicine, Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Fan
F
Yang
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Huan-Ling
HL
Zhu
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Chuan
C
He
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Jian-Jun
JJ
Li
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Bing
B
Xiang
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Xu
X
Cui
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Jie
J
Huang
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Jie
J
Ji
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Hong-Bing
HB
Ma
Department of Haematology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, China.
Ting
T
Liu
HBV reactivation; Non-Hodgkin’s lymphoma; Nucleoside/nucleotide analogue; Rituximab