Reactivation of hepatitis B virus in cancer patients treated with chemotherapy for solid tumors. Is the prophylaxis really required?
Reactivation of hepatitis B virus in cancer patients treated with chemotherapy for solid tumors. Is the prophylaxis really required?
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DOI：
10.1016/j.dld.2016.11.004
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发表时间：
2017-02-01
影响因子：
4.5
通讯作者：
Gaeta, Giovanni Battista
中科院分区：
文献类型：
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作者：
Federico, Alessandro;Brancaccio, Giuseppina;Gaeta, Giovanni Battista
背景：乙肝病毒在非血液学肿瘤化疗期间的再激活尚不完全清楚。目的：评价乙型肝炎病毒携带者肿瘤实体瘤化疗后乙型肝炎病毒再激活的风险。方法：连续纳入267例实体瘤患者，其中乙型肝炎s抗原阳性13例（4.8%），无活性携带者6例，慢性肝病7例。32例（12%）乙型肝炎s抗原阴性/乙型肝炎c抗体阳性。乙型肝炎病毒无活性携带者每3个月随访一次丙氨酸转氨酶、乙型肝炎病毒- dna；乙型肝炎病毒隐匿携带者每3个月进行一次丙氨酸转氨酶和乙型肝炎s抗原检测。结果：38例未接受预防治疗的非活动性或隐匿性乙型肝炎感染患者在随访期间均未出现乙型肝炎病毒再激活。结论：本研究提示，在实体瘤化疗的乙肝s抗原阴性患者中，乙肝和c抗体筛查结果与临床决策无关，可以避免。需要更大规模的研究来确定化疗期间HBV再激活的风险在这部分患者中是否可以忽略不计，并且他们无法监测HBV再激活。(C) 2016 Editrice gastroenteritaliana S.r.l, Elsevier Ltd.出版版权所有。
Background: Reactivation of hepatitis B virus during cancer chemotherapy for non-hematological tumors is not fully clear.Aim: To evaluate the risk of hepatitis B virus reactivation in carriers of hepatitis B virus cancer patients treated with chemotherapy for solid tumors.Methods: Two hundred sixty-seven patients with solid tumors were consecutively enrolled: 13 (4.8%) were hepatitis B s-antigen positive, of whom 6 were documented inactive carriers and 7 had chronic liver disease. Thirty-two patients (12%) were hepatitis B s-antigen negative/hepatitis B c-antibody positive. Hepatitis B virus inactive carriers were followed every 3 months by alanine aminotransferases, hepatitis B virus-DNA; whereas hepatitis B virus occult carriers were followed every 3 months by alanine aminotransferases and hepatitis B s-antigen.Results: None of the 38 total patients with inactive or occult B infection who did not receive prophylaxis presented hepatitis B virus reactivation during the follow-up period.Conclusion: This study suggests that, in hepatitis B s-antigen negative patients who undergo chemotherapy for solid tumors, hepatitis B and c-antibody screening results are not relevant to clinical decision and can be avoided. Larger studies are needed to establish whether the risk of reactivation of HBV during chemotherapy is negligible in this subset of patients and they could not be monitored for HBV reactivation. (C) 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.