title: Hepatitis B virus reactivation during anti-cancer chemotherapy in patients with past hepatitis B virus infection.
abstract: OBJECTIVE
  The necessity of preemptive antiviral therapy in patients with past HBV infection is uncertain. We evaluated the incidence and risk factors of HBV reactivation in cancer patients with past HBV infection who received anti-cancer chemotherapy.
  
  
  METHODS
  Between Jan. 2009 and Dec. 2011, we reviewed 675 HBsAg negative and anti-HBc positive patients who had solid cancers or hematologic malignancies that were treated with intravenous cytotoxic chemotherapy.
  
  
  RESULTS
  Among 675 patients, 321 (47.6%) patients had solid cancer and 354 (52.4%) had hematologic malignancy. HBV reactivation was observed in 13 patients (1.9%). In solid cancer patients, 1 (0.3%) patient had HBV reactivation, whereas 12 out of 365 (3.3%) patients with hematologic malignancy experienced HBV reactivation. Among the 12 HBV-reactivated patients with hematologic malignancy, 11 patients had lymphoma. Lymphoma carried a significantly higher risk for HBV reactivation than solid cancer in patients with past HBV infection (OR, 24.134; 95% CI, 3.027-192.406; P = 0.003). Among HBV-reactivated lymphoma patients, 2 patients experienced fulminant liver failure. The absence of anti- HBs was identified as a risk factor for HBV reactivation (OR, 22.446; 95% CI, 4.816-104.609; P < 0.001).
  
  
  CONCLUSIONS
  Preemptive antiviral therapy should be considered in lymphoma patients with past HBV infection before starting anti-cancer chemotherapy
authors.forename: Eun
authors.initials: E
authors.lastname: Kim
authors.forename: Sehyo
authors.initials: S
authors.lastname: Yune
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Ha
authors.forename: Woo Joo
authors.initials: WJ
authors.lastname: Lee
authors.forename: Ji-won
authors.initials: JW
authors.lastname: Hwang
authors.forename: Yong-Han
authors.initials: YH
authors.lastname: Paik
authors.forename: Geum Youn
authors.initials: GY
authors.lastname: Gwak
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Choi
authors.forename: Joon Hyeok
authors.initials: JH
authors.lastname: Lee
authors.forename: Kwang Cheol
authors.initials: KC
authors.lastname: Koh
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014775:Virus Activation / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens