title: Viral Outcome in Patients with Occult HBV Infection or HCV-Ab Positivity Treated for Lymphoma.
abstract: HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivationis strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Guarino
authors.affiliation: Department of Clinical Medicine and Surgery, Haematology Units, University of Naples Federico II, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Picardi
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Vitello
authors.affiliation: Department of Clinical Medicine and Surgery, Haematology Units, University of Naples Federico II, Naples, Italy.
authors.forename: Novella
authors.initials: N
authors.lastname: Pugliese
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Rea
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cossiga
authors.affiliation: Department of Clinical Medicine and Surgery, Haematology Units, University of Naples Federico II, Naples, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pane
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Caporaso
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.
authors.forename: Filomena
authors.initials: F
authors.lastname: Morisco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D005260:Female; D016174:Hepacivirus / Q000276:immunology / Q000472:pathogenicity*; D006509:Hepatitis B / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control / Q000821:virology*; D006515:Hepatitis B virus / Q000276:immunology / Q000472:pathogenicity*; D006526:Hepatitis C / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control / Q000821:virology*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007558:Italy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab / Q000009:adverse effects*; D062606:Tertiary Care Centers; D014775:Virus Activation; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents; D015415:Biomarkers; D018937:Hepatitis C Antibodies; D000069283:Rituximab
keywords: HCV infection; chemotherapy; occult HBV infection; rituximab