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Eighteen‐month lamivudine prophylaxis on preventing occult hepatitis B virus infection reactivation in patients with haematological malignancies receiving immunosuppression therapy
Author(s) -
Marrone A.,
Capoluongo N.,
D'Amore C.,
Pisaturo M.,
Esposito M.,
Guastafierro S.,
Siniscalchi I.,
Macera M.,
Boemio A.,
Onorato L.,
Rinaldi L.,
Minichini C.,
Adinolfi L. E.,
Sagnelli E.,
Mastrullo L.,
Coppola N.
Publication year - 2018
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12802
Subject(s) - medicine , lamivudine , discontinuation , gastroenterology , immunosuppression , chemotherapy , hepatitis b virus , lymphoma , hepatitis b , hematology , immunology , virus
Summary This study evaluated the long‐term efficacy and safety of an 18‐month lamivudine prophylaxis in 68 HB sAg‐negative/anti– HB c‐positive patients with oncohaematological disease. All 68 consecutive HB sAg‐negative/anti– HB c‐positive patients with an oncohaematological disease and naïve for chemotherapy observed from April 2008 to December 2012 at 2 Hematology Units in Naples were treated with lamivudine for 18 months after stopping chemotherapy and monitored for HB sAg at months 1 and 3 during chemotherapy and then every 3 months after its discontinuation. During follow‐up, 13 (19.1%) of the 68 patients died of complications related to their oncohaematological disease, and 3 (4%) showed a virological HBV reactivation (retroconversion to HB sAg positivity) 1‐7 months after the discontinuation of lamivudine prophylaxis (2 treated for chronic lymphocytic leukaemia and one for Waldenstrom's disease); of these, 2 showed a biochemical reactivation. Comparing the demographic and clinical characteristics of the 3 patients with a virological HBV reactivation to the 65 without, the former were older (median age and range: 67 years [75‐78] vs. 61 [24‐88]; P = .05) and were less frequently treated for B‐cell non‐Hodgkin lymphoma (B‐ NHL ) (0 vs. 70.7%, P = .03). In conclusion, a 18 months of lamivudine prophylaxis was effective in preventing HBV reactivation in HB sAg‐negative/anti– HB c‐positive patients treated for B‐ NHL . However, in patients with chronic and severe immunodepression, such as those with chronic lymphocytic leukaemia and Waldenstrom's disease, prophylaxis should be continued for an indefinite period.