Abstract
In the absence of prophylaxis, the reactivation of hepatitis B in oncology patients who are hepatitis B carriers is a well-known and often fatal complication of chemotherapy. The current recommendations in Canada and the USA are that patients who are positive for hepatitis B surface antigen (HBsAg) receive antiviral prophylaxis prior to chemotherapy. We report a 67-year-old man with B-cell lymphoma who developed hepatitis B reactivation following chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone and rituximab. Pre-chemotherapy, the patient was negative for HBsAg, positive for hepatitis B core antibody (anti-HBc) and weakly positive for hepatitis B surface antibody. Despite treatment with lamivudine, the patient died of fulminant hepatic failure. Our experience indicates that patients who are negative for HBsAg but positive for anti-HBc are still at risk for reactivation of latent hepatitis B during and after chemotherapy and may be considered for prophylaxis.
Original language | English (US) |
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Pages (from-to) | 1085-1089 |
Number of pages | 5 |
Journal | Leukemia and Lymphoma |
Volume | 46 |
Issue number | 7 |
DOIs | |
State | Published - 2005 |
Externally published | Yes |
Keywords
- Chemotherapy
- Core antibody
- Hepatitis B
- Lymphoma
- Reactivation
- Surface antigen
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research