Hepatitis B virus reactivation in patients with hematological malignancies under lamivudine prophylaxis
Acta Medica Mediterranea, cilt.35, sa.5, ss.2417-2422, 2019 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 35 Sayı: 5
- Basım Tarihi: 2019
- Doi Numarası: 10.19193/0393-6384_2019_5_377
- Dergi Adı: Acta Medica Mediterranea
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.2417-2422
- Anahtar Kelimeler: HBV reactivation, Hematological malignancies, Lamivudine Antiviral prophylaxis, Rituximab
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: Suppression of immune system in patients with inactive chronic hepatitis B virus (HBV) infection may result in HBV reactivation with its associated morbidity and mortality. The risk is higher in hematological malignancies because of the high level of immunosuppression especially in patients receiving monoclonal antibodies directed to B and T lymphocytes. We evaluated the outcome of antiviral prophylaxis with lamivudine in patients presenting with hematological malignancies and HBV infection. Materials and methods: Patients with hematological malignancies and inactive chronic HBV infection who received lamivudine prophylaxis during and at least one year after chemotherapy were evaluated in this study. Clinical and laboratory findings of patients were retrospectively evaluated. HBV reactivation was defined as reappearance or ≥ 10-fold increase in HBV DNA levels. In the case of HBV reactivation, lamivudine had been switched to the potent antiviral; tenofovir disoproxil that has not cross resistance with lamivudine. Results: Twenty-four patients were enrolled in the study. HBV reactivation occurred in 20.8% of patients. It occurred during the first 6 months of lamivudine prophylaxis. All of the reactivated patients had received rituximab-based chemotherapy. We detected statistically significant relationship between rituximab use and HBV reactivation (P = 0.024). There was not any relationship between age, sex, initial HBV DNA levels and steroid use with HBV reactivation (P> 0.05). Conclusion: This study emphasizes the need to prophylactic use of potent antivirals in patients receiving aggressive immunosuppressive treatments with a high risk of HBV reactivation.