title: Reactivation of hepatitis B virus in cancer patients treated with chemotherapy for solid tumors. Is the prophylaxis really required?
abstract: BACKGROUND
  Reactivation of hepatitis B virus during cancer chemotherapy for non-hematological tumors is not fully clear.
  
  
  OBJECTIVE
  To evaluate the risk of hepatitis B virus reactivation in carriers of hepatitis B virus cancer patients treated with chemotherapy for solid tumors.
  
  
  METHODS
  Two hundred sixty-seven patients with solid tumors were consecutively enrolled: 13 (4.8%) were hepatitis B s-antigen positive, of whom 6 were documented inactive carriers and 7 had chronic liver disease. Thirty-two patients (12%) were hepatitis B s-antigen negative/hepatitis B c-antibody positive. Hepatitis B virus inactive carriers were followed every 3 months by alanine aminotransferases, hepatitis B virus-DNA; whereas hepatitis B virus occult carriers were followed every 3 months by alanine aminotransferases and hepatitis B s-antigen.
  
  
  RESULTS
  None of the 38 total patients with inactive or occult B infection who did not receive prophylaxis presented hepatitis B virus reactivation during the follow-up period.
  
  
  CONCLUSIONS
  This study suggests that, in hepatitis B s-antigen negative patients who undergo chemotherapy for solid tumors, hepatitis B and c-antibody screening results are not relevant to clinical decision and can be avoided. Larger studies are needed to establish whether the risk of reactivation of HBV during chemotherapy is negligible in this subset of patients and they could not be monitored for HBV reactivation.
authors.affiliation: Division of Hepatogastroenterology, Second University of Naples, Naples, Italy. Electronic address: alessandro.federico@unina2.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Federico
authors.affiliation: Division of Infectious Diseases and Viral Hepatitis, Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Brancaccio
authors.affiliation: Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Dallio
authors.affiliation: Division of Oncology, S. Giovanni di Dio Hospital, Frattamaggiore, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Iodice
authors.affiliation: Division of Oncology, Second University of Naples, Naples, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Fabozzi
authors.affiliation: Division of Oncology, S. Giovanni di Dio Hospital, Frattamaggiore, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Del Prete
authors.affiliation: Division of Oncology, Second University of Naples, Naples, Italy.
authors.forename: Fortunato
authors.initials: F
authors.lastname: Ciardiello
authors.affiliation: Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Loguercio
authors.affiliation: Division of Infectious Diseases and Viral Hepatitis, Naples, Italy.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Gaeta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000008:administration & dosage; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000502:physiology; D006801:Humans; D007558:Italy; D019259:Lamivudine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*; D014775:Virus Activation
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine; D000410:Alanine Transaminase
keywords: Chemotherapy; Immunosuppressive therapy; Occult hepatitis B virus infection; Prophylaxis