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Multicenter cooperative case survey of hepatitis B virus reactivation by chemotherapeutic agents
Author(s) -
Takahashi Hideaki,
Ikeda Masafumi,
Kumada Takashi,
Osaki Yukio,
Kondo Shunsuke,
Kusumoto Shigeru,
Ohkawa Kazuyoshi,
Nadano Seijin,
Furuse Junji,
Kudo Masatoshi,
Ito Kiyoaki,
Yokoyama Masahiro,
Okusaka Takuji,
Shimoyama Masanori,
Mizokami Masashi
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12496
Subject(s) - medicine , hbsag , chemotherapy , hepatitis b virus , malignancy , hepatitis b , gastroenterology , complication , immunology , virus
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.