Evaluating Hepatitis B Virus Reactivation During Solid Tumor Chemotherapy: Evidence to Guide Pretreatment Hepatitis B Screening and Prophylaxis

Editorials5 January 2016Evaluating Hepatitis B Virus Reactivation During Solid Tumor Chemotherapy: Evidence to Guide Pretreatment Hepatitis B Screening and ProphylaxisVincent Lo Re III, MD, MSCE and Mindy Schuster, MD, MSCEVincent Lo Re III, MD, MSCEFrom University of Pennsylvania, Philadelphia, Pennsylvania. and Mindy Schuster, MD, MSCEFrom University of Pennsylvania, Philadelphia, Pennsylvania.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2722 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Reactivation of hepatitis B virus (HBV) infection is increasingly recognized as a complication of immunosuppressive therapy, particularly chemotherapy. It is characterized by an abrupt increase in HBV DNA level among patients with positive hepatitis B surface antigen (HBsAg) or the reappearance of serum HBV DNA in those with serologic evidence of resolved infection (negative HBsAg and positive core antibody [HBcAb] with or without HBV surface antibody). It is usually accompanied by elevations in liver aminotransferase levels. Reactivation can lead to serious hepatic injury, chemotherapy interruption, liver failure, and death (1).Reactivation of HBV occurs because after infection, the virus establishes ...References1. Lok AS, Ward JW, Perrillo RP, McMahon BJ, Liang TJ. Reactivation of hepatitis B during immunosuppressive therapy: potentially fatal yet preventable. Ann Intern Med. 2012;156:743-5. [PMID: 22586011] LinkGoogle Scholar2. Loomba R, Rowley A, Wesley R, Liang TJ, Hoofnagle JH, Pucino F, et al. Systematic review: the effect of preventive lamivudine on hepatitis B reactivation during chemotherapy. 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American Society of Clinical Oncology provisional clinical opinion: chronic hepatitis B virus infection screening in patients receiving cytotoxic chemotherapy for treatment of malignant diseases. J Clin Oncol. 2010;28:3199-202. [PMID: 20516452] CrossrefMedlineGoogle Scholar7. Day FL, Link E, Thursky K, Rischin D. Current hepatitis B screening practices and clinical experience of reactivation in patients undergoing chemotherapy for solid tumors: a nationwide survey of medical oncologists. J Oncol Pract. 2011;7:141-7. [PMID: 21886492] CrossrefMedlineGoogle Scholar8. Paul S, Saxena A, Terrin N, Viveiros K, Blak EM, Wong JB. Hepatitis B virus reactivation and prophylaxis during solid tumor chemotherapy. A systematic review and meta-analysis. Ann Intern Med. 2016;164:30-40. doi:10.7326/M15-1121 LinkGoogle Scholar9. Perrillo RP, Gish R, Falck-Ytter YT. American Gastroenterological Association Institute technical review on prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148:221-244. [PMID: 25447852] CrossrefMedlineGoogle Scholar10. Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT; American Gastroenterological Association Institute. American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148:215-9; quiz e16-7. [PMID: 25447850] doi:10.1053/j.gastro.2014.10.039 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Pennsylvania, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2722.Corresponding Author: Vincent Lo Re III, MD, MSCE, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104; e-mail, [email protected]med.upenn.edu.Current Author Addresses: Dr. Lo Re: Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104.Dr. Schuster: Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, 3 Silverstein, Suite E, 3400 Spruce Street, Philadelphia, PA 19104.This article was published online first at www.annals.org on 24 November 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHepatitis B Virus Reactivation and Prophylaxis During Solid Tumor Chemotherapy Sonali Paul , Akriti Saxena , Norma Terrin , Kathleen Viveiros , Ethan M. Balk , and John B. Wong Metrics Cited byMitomycin, 5-fluorouracil, leflunomide, and mycophenolic acid directly promote hepatitis B virus replication and expression in vitroA new approach for cancer treatment: from specific induction of breast cancer to innovative gold-nanoparticle mediated thermal therapiesProphylactic effect of lamivudine on chemotherapy-induced hepatitis B virus reactivation in patients with solid tumour: A meta-analysisHIV, Aging, and Viral Coinfections: Taking the Long ViewCancer and liver cirrhosis: implications on prognosis and management 5 January 2016Volume 164, Issue 1Page: 64-65KeywordsCancer chemotherapyChemotherapyDNAGastroenterology and hepatologyHepatitis B virusImmunosuppressivesInfectious disease immunologyLiverLiver diseasesProphylaxis ePublished: 24 November 2015 Issue Published: 5 January 2016 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...