Prospective evaluation of seropositive occult hepatitis B viral infection in lymphoma patients receiving chemotherapy

• Published in: Hong Kong medical journal = Xianggang yi xue za zhi 2011-10, Vol.17 (5), p.376-380
• Main Authors: Cheung, W I, Lin, S Y, Leung, Vincent K S, Fung, Kitty S C, Lam, Y K, Lo, F H, Chau, T N
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Antiviral Agents - therapeutic use; Carrier State - immunology; Chemotherapy; Cyclophosphamide - administration & dosage; Deoxyribonucleic acid; DNA; DNA, Viral - blood; Epirubicin - administration & dosage; Female; Guanine - analogs & derivatives; Guanine - therapeutic use; Hepatitis B; Hepatitis B - complications; Hepatitis B - drug therapy; Hepatitis B - immunology; Hepatitis B Antibodies - blood; Hepatitis B Core Antigens - blood; Hepatitis B Surface Antigens - blood; Hepatitis B virus - immunology; Humans; Liver Function Tests; Lymphoma; Lymphoma - complications; Lymphoma - drug therapy; Lymphoma - immunology; Male; Middle Aged; Prednisolone - administration & dosage; Prospective Studies; Rituximab; Time Factors; Vincristine - administration & dosage; Viral infections; Viral Load
• ISSN: 1024-2708; 2226-8707

OBJECTIVE. To serially evaluate the viral kinetics of occult hepatitis B virus infection in lymphoma patients and perform a correlation with clinical outcomes. DESIGN. Case series with 1-year follow-up. SETTING. Regional hospital, Hong Kong. PATIENTS. Consecutive patients who were newly diagnosed to have lymphoma in the hospital between 1 April 2007 and 31 March 2008 were tested for hepatitis B (HB) surface (s) antigen (Ag), anti-HBs antibody (Ab) and anti-HB core (c) Ab. Seropositive occult hepatitis B patients as defined by being negative for HBsAg but positive anti-HBsAb and/or anti-HBcAb without a hepatitis B vaccination history were recruited. Serum HBsAg, anti-HBsAb, anti-HBcAb, hepatitis B virus deoxyribonucleic acid (DNA) level, and liver biochemistry were checked at baseline and every 4 weeks during and after chemotherapy until 12 months after the completion of chemotherapy or death. Entecavir was started if patients developed biochemical flare-up of hepatitis B associated with virological rebound. The prevalence and course of hepatitis B virus-related hepatitis, as well as any temporal relationship to viral kinetics and clinical hepatitis, were assessed. RESULTS. Of 47 patients tested, 10 (21%) with lymphoma were seropositive occult hepatitis carriers. Their median baseline hepatitis B virus DNA level was 89 IU/mL (range,