Abstract
To prospectively evaluate the prevalence of hepatitis B virus (HBV) positivity and study the evolution of HBV profile during cancer chemotherapy, serum HBV markers and liver biochemistry were determined in 1008 of 1402 (72%) cancer patients admitted in our Unit and in all 920 (91%) who received chemotherapy. We found that 54 (5.3%) were HBsAg carriers while 443 (44%) had at least one HBV marker positive. Of the latter, 405 (91%) were HBcAb+ve, 321 (72%) HBsAb+ve and 212 (48%) HBeAb+ve. No patient was HBeAg+ve. Among 920 chemotherapy receivers, 374 (41%) were HBcAb+ve, 280 (30%) HBsAb+ve and 178 (19%) HBeAb+ve. Fifty (5.4%) were HBsAg carriers (versus 0.6% in Greek blood donors). All 50 were systematically screened for HBsAg and HBsAb status throughout chemotherapy, during follow-up or until their death, and liver biochemistry was performed before each chemotherapy course. Stable antigenaemia was observed in 43/50 (86%) while 7/50 (14%) developed clinical and/or biochemical hepatitis. Six of these seven developed serum anti-HBs antibodies with an associated decrease of serum HBsAg titres. We conclude that reactivation of HBV infection during chemotherapy is not rare (14%), while disappearance of HBs antigenaemia is neither a frequent nor usually a permanent phenomenon. © 1999 Cancer Research Campaign
Keywords: HBsAg carriers, HBV profile, cancer chemotherapy
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- Galbraith R. M., Eddleston A. L., Williams R., Zuckerman A. J. Fulminant hepatic failure in leukaemia and choriocarcinoma related to withdrawal of cytotoxic drug therapy. Lancet. 1975 Sep 20;2(7934):528–530. doi: 10.1016/s0140-6736(75)90897-1. [DOI] [PubMed] [Google Scholar]
- Nakamura Y., Motokura T., Fujita A., Yamashita T., Ogata E. Severe hepatitis related to chemotherapy in hepatitis B virus carriers with hematologic malignancies. Survey in Japan, 1987-1991. Cancer. 1996 Nov 15;78(10):2210–2215. doi: 10.1002/(sici)1097-0142(19961115)78:10<2210::aid-cncr24>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
- Ohtsu T., Sai T., Oka M., Sugai Y., Tobinai K. Activation of hepatitis B virus infection by chemotherapy containing glucocorticoid in hepatitis B virus carriers with hematologic malignancies. Jpn J Clin Oncol. 1991 Oct;21(5):360–365. [PubMed] [Google Scholar]
- Scullard G. H., Smith C. I., Merigan T. C., Robinson W. S., Gregory P. B. Effects of immunosuppressive therapy on viral markers in chronic active hepatitis B. Gastroenterology. 1981 Dec;81(6):987–991. [PubMed] [Google Scholar]
- Wands J. R., Chura C. M., Roll F. J., Maddrey W. C. Serial studies of hepatitis-associated antigen and antibody in patients receiving antitumor chemotherapy for myeloproliferative and lymphoproliferative disorders. Gastroenterology. 1975 Jan;68(1):105–112. [PubMed] [Google Scholar]