Hideaki Takahashi1, Masafumi Ikeda1, Takashi Kumada2, Yukio Osaki3, Shunsuke Kondo4, Shigeru Kusumoto5, Kazuyoshi Ohkawa6, Seijin Nadano7, Junji Furuse8, Masatoshi Kudo9, Kiyoaki Ito10,11, Masahiro Yokoyama12, Takuji Okusaka4, Masanori Shimoyama13, Masashi Mizokami10. 1. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa. 2. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki. 3. Departments of Gastroenterology and Hepatology, Osaka Red Cross Hospital. 4. Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases. 5. Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka. 6. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital. 7. Department of Internal Medicine, Medical Oncology, Kyorin University School of Medicine. 8. Division of Medical Oncology and Hematology, Cancer Institute Hospital. 9. Multi-institutional Clinical Trial Support Center, National Cancer Center, Tokyo. 10. Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya. 11. Department of Gastroenterology, National Hospital Organization Shikoku Cancer Center, Matsuyama. 12. The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa. 13. Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
Abstract
AIM: The purpose of this multicenter cooperative study was to elucidate the clinical features of hepatitis B virus (HBV) reactivation by chemotherapeutic agents and the patient outcomes after HBV reactivation by a retrospective review of accumulated patients' medical records. METHODS: Records of a total of 27 patients (hematological malignancy, 14 patients; solid tumor, 13 patients) from 11 institutions who were diagnosed between June 2005 and October 2010 as having HBV reactivation following chemotherapy were reviewed. RESULTS: Of the 27 patients with reactivation, 16 patients were hepatitis B surface antigen (HBsAg) positive and 11 were HBsAg negative prior to the commencement of chemotherapy. Of the 11 patients who were HBsAg negative prior to the chemotherapy, 10 had hematological malignancies and one had a solid tumor. Of the 14 patients with hematological malignancies with HBV reactivation enrolled in the study, the reactivation occurred more than 12 months after the completion of chemotherapy in five patients (36%); on the other hand, none of the patients (0%) with solid tumors developed HBV reactivation more than 12 months after the completion of chemotherapy. Of the 24 patients who had acute liver dysfunction at the diagnosis of HBV reactivation, nine (38%) had severe hepatitis and seven (29%) died of liver failure. CONCLUSION: Most of the patients with HBV reactivation who were HBsAg negative prior to the chemotherapy had underlying hematological malignancies. Furthermore, patients with hematological malignancies often developed late-onset HBV reactivation. The prognosis of patients who develop acute liver dysfunction as a complication of HBV reactivation is extremely dismal.
AIM: The purpose of this multicenter cooperative study was to elucidate the clinical features of hepatitis B virus (HBV) reactivation by chemotherapeutic agents and the patient outcomes after HBV reactivation by a retrospective review of accumulated patients' medical records. METHODS: Records of a total of 27 patients (hematological malignancy, 14 patients; solid tumor, 13 patients) from 11 institutions who were diagnosed between June 2005 and October 2010 as having HBV reactivation following chemotherapy were reviewed. RESULTS: Of the 27 patients with reactivation, 16 patients were hepatitis B surface antigen (HBsAg) positive and 11 were HBsAg negative prior to the commencement of chemotherapy. Of the 11 patients who were HBsAg negative prior to the chemotherapy, 10 had hematological malignancies and one had a solid tumor. Of the 14 patients with hematological malignancies with HBV reactivation enrolled in the study, the reactivation occurred more than 12 months after the completion of chemotherapy in five patients (36%); on the other hand, none of the patients (0%) with solid tumors developed HBV reactivation more than 12 months after the completion of chemotherapy. Of the 24 patients who had acute liver dysfunction at the diagnosis of HBV reactivation, nine (38%) had severe hepatitis and seven (29%) died of liver failure. CONCLUSION: Most of the patients with HBV reactivation who were HBsAg negative prior to the chemotherapy had underlying hematological malignancies. Furthermore, patients with hematological malignancies often developed late-onset HBV reactivation. The prognosis of patients who develop acute liver dysfunction as a complication of HBV reactivation is extremely dismal.
Authors: Olympia E Anastasiou; Martin Theissen; Jens Verheyen; Barbara Bleekmann; Heiner Wedemeyer; Marek Widera; Sandra Ciesek Journal: Viruses Date: 2019-09-16 Impact factor: 5.048