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

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    <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

    Patient disposition and clinical outcomes.

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    <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

    Clinical data of 11 patients with hepatitis B reactivation without antiviral prophylaxis before chemotherapy.

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    <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

    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.

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    <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
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