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01-04-2013 | Research Article

An optimized antiviral modification strategy for prevention of hepatitis B reactivation in patients undergoing prophylactic lamivudine and chemotherapy: a pilot study

Authors: Xiang-Yuan Wu, Xing Li, Zhan-Hong Chen, Jing-Yun Wen, Qu Lin, Yan-Fang Xing, Min Dong, Li Wei, Tian-Tian Wang, Jie Chen, Ze-Xiao Lin, Xiang-bo Wan, Dan-Yun Ruan, Xiao-Kun Ma

Published in: Tumor Biology | Issue 2/2013

Abstract

In patients receiving prophylactic lamivudine (LAM) and chemotherapy, hepatitis B virus (HBV) reactivation cannot be eliminated without knowing the latent causes and optimal management. In our previous study, virus breakthrough and relapse were highly suspected as potential virologic causes for HBV reactivation. Therefore, we reviewed 24 previous studies and 447 patients who underwent chemotherapy and prophylactic LAM, with an incidence of 7.2 % HBV reactivation. Virus breakthrough and relapse were seldom investigated in these studies. In addition, 72 patients that underwent prophylactic LAM and chemotherapy at our centers were also analyzed. Among them, eight patients developed virus breakthrough, with another nine developing virus relapse after discontinuation of LAM. Eight patients received antiviral modification, which included administration of adefovir for patients with virus breakthrough or resumption of LAM for patients with virus relapse and none of them developed HBV reactivation. In contrast, of the nine patients who did not receive antiviral modification, six developed HBV reactivation and two died. In conclusion, this study demonstrated that virus breakthrough and relapse were the critical causative factors of HBV reactivation in patients receiving chemotherapy and prophylactic LAM. An optimized antiviral modification strategy could effectively prevent HBV reactivation in patients with virus breakthrough or relapse.

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Title: An optimized antiviral modification strategy for prevention of hepatitis B reactivation in patients undergoing prophylactic lamivudine and chemotherapy: a pilot study
Authors: Xiang-Yuan Wu
Xing Li
Zhan-Hong Chen
Jing-Yun Wen
Qu Lin
Yan-Fang Xing
Min Dong
Li Wei
Tian-Tian Wang
Jie Chen
Ze-Xiao Lin
Xiang-bo Wan
Dan-Yun Ruan
Xiao-Kun Ma
Publication date: 01-04-2013
Publisher: Springer Netherlands
Published in: Tumor Biology / Issue 2/2013
Print ISSN: 1010-4283
Electronic ISSN: 1423-0380
DOI: https://doi.org/10.1007/s13277-012-0626-6

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