16 research outputs found
Risk of Severe Acute Exacerbation of Chronic HBV Infection Cancer Patients Who Underwent Chemotherapy and Did Not Receive Anti-Viral Prophylaxis
<div><p>Background</p><p>Reactivation of HBV replication with an increase in serum HBV DNA and alanine aminotransferase (ALT) activity has been reported in 20–50% of hepatitis B carriers undergoing cytotoxic chemotherapy for cancer treatment. Manifestation of HBV reactivation ranges from asymptomatic self-limiting hepatitis to severe progressive hepatic failure and fatal consequences.</p><p>Aim</p><p>To investigate the risk of severe acute exacerbation of chronic HBV infection in HBsAg-positive cancer patients with solid tumors or hematological malignancies who underwent chemotherapy without antiviral prophylaxis.</p><p>Methods</p><p>A retrospective review of charts was conducted for HBsAg-positive cancer patients in our institution who underwent chemotherapy and did not receive anti-viral prophylaxis between the periods of July 2007 to January 2013. We investigate the incidence of severe acute exacerbation of chronic HBV infection if these patients with a variety of solid tumors and hematological malignancies.</p><p>Results</p><p>A total of 156 patients (hematological malignancies: 16; solid tumors: 140) were included. The incidence of severe acute HBV exacerbation in the patients with hematological malignancy was higher than that in solid tumors (25.0% [4/16] <i>vs</i> 4.3% [6/140]); <i>P</i> = 0.005). Additionally, patients receiving rituximab-based chemotherapy had higher acute exacerbation rate than those with non-rituximab-based chemotherapy (40.0% <i>vs</i> 4.1%, <i>P</i> = 0.001). Among the patients with solid tumors, the incidences of severe acute exacerbation of chronic HBV in hepatocellular carcinoma, colorectal cancer, lung cancer, breast cancer, gynecological cancer, urological tract cancer, head/neck cancer and other solid malignancies were 2.3%, 4.0%, 7.1%, 9.0%, 16.7%, 6.7%, 0% and 0%, respectively.</p><p>Conclusion</p><p>Severe acute exacerbation of chronic HBV infection may occur in HBsAg-positive patients with a variety of solid tumors who received chemotherapy without adequate anti-viral prophylaxis. Hematological malignancy and rituximab-based chemotherapy are the risk factors related to severe acute exacerbation of chronic HBV infection in HBsAg-positive cancer patients undergoing chemotherapy.</p></div
Severe acute exacerbation of HBV infection in HBsAg-positive cancer patients who received chemotherapy without antiviral prophylaxis.
<p>Severe acute exacerbation of HBV infection in HBsAg-positive cancer patients who received chemotherapy without antiviral prophylaxis.</p
Characteristics of the 156 HBsAg-positive cancer patients who received chemotherapy without antiviral prophylaxis.
<p>Characteristics of the 156 HBsAg-positive cancer patients who received chemotherapy without antiviral prophylaxis.</p
Patient disposition and clinical outcomes.
<p>A total of 156 patients were included for HBsAg-positive cancer patients in our institution who underwent chemotherapy and did not receive anti-viral prophylaxis between the periods of July 2007 to January 2013.</p
Flow chart of patients with or without screening for hepatitis B surface antigen (HBsAg), antiviral prophylaxis and hepatitis B virus reactivation in overall (n = 1053) by way of the computer-assisted reminding system.
<p>Flow chart of patients with or without screening for hepatitis B surface antigen (HBsAg), antiviral prophylaxis and hepatitis B virus reactivation in overall (n = 1053) by way of the computer-assisted reminding system.</p
The rates of reactivation of hepatitis B and related events in patients (n = 134) with and without antiviral prophylaxis before prescribing chemotherapy.
<p>The rates of reactivation of hepatitis B and related events in patients (n = 134) with and without antiviral prophylaxis before prescribing chemotherapy.</p
Clinical data of 11 patients with hepatitis B reactivation without antiviral prophylaxis before chemotherapy.
<p>ALT, alanine aminotransferase; HCC, hepatocellular carcinoma; NA, not available; C/T, chemotherapy; ETV, entecavir; LdT, telbivudine; LAM, lamivudine; TDF, tenofovir.</p><p>All patients were hepatitis B e antigen-negative.</p><p>Case 5, Case 7, Case 10 reported themselves to be inactive HBV carriers in other medical institutions.</p><p>Case 11 died within 2 days after admission without virological data and antiviral treatment.</p><p>Clinical data of 11 patients with hepatitis B reactivation without antiviral prophylaxis before chemotherapy.</p
Flow chart of the strategy of computer-assisted system for reminding the doctors in charge before prescribing chemotherapy.
<p>Flow chart of the strategy of computer-assisted system for reminding the doctors in charge before prescribing chemotherapy.</p
Hepatitis B reactivation during systemic cytotoxic chemotherapy in solid tumor patients with a baseline HBV DNA level equal to or more than 2000 IU/mL and using prophylactic entecavir and lamivudine.
<p>Hepatitis B reactivation during systemic cytotoxic chemotherapy in solid tumor patients with a baseline HBV DNA level equal to or more than 2000 IU/mL and using prophylactic entecavir and lamivudine.</p
Demographic data of cancer patients in overall (n = 1053) who receiving chemotherapy shown by baseline characteristics, departments of doctors, cancer types and regimens of chemotherapy.
<p>ALT, alanine transaminase; HBsAg, hepatitis B surface antigen; HCV Ab, hepatitis C virus antibody. ALT, alanine transaminase; HBsAg, hepatitis B surface antigen; HCV Ab, hepatitis C virus antibody.</p><p>Demographic data of cancer patients in overall (n = 1053) who receiving chemotherapy shown by baseline characteristics, departments of doctors, cancer types and regimens of chemotherapy.</p