Clinical characteristics and molecular analysis of hepatitis B virus reactivation in hepatitis B surface antigen-negative patients during or after immunosuppressive or cytotoxic chemotherapy

Hayashi, Kazuhiko; Ishigami, Masatoshi; Ishizu, Yoji; Kuzuya, Teiji; Honda, Takashi; Tachi, Yoshihiko; Ishikawa, Tetsuya; Katano, Yoshiaki; Yoshioka, Kentaro; Toyoda, Hidenori; Kumada, Takashi; Goto, Hidemi; Hirooka, Yoshiki

doi:10.1007/s00535-016-1187-z

Cited by 24 publications

(21 citation statements)

References 35 publications

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“…2 Immune system hypofunction and the use of immunosuppressive agents can lead to OBI reactivation and recurrence of typical serological evidence of infection. 3,4 The persistence of HBV DNA in the livers of individuals with OBI may provoke a mild but continuing necroinflammation, contributing to the progression of liver disease and increasing the risk of tumorigenesis. [5][6][7] The incidence of OBI was influenced by HBVendemic areas, the particular population studied, the public health status of the area, and screening methodology; and incidence differed extensively from previously reported values.…”

Section: Discussionmentioning

confidence: 99%

“…OBI can be transmitted through blood transfusion, parturition, liver transplantation, and even through close contact . Immune system hypofunction and the use of immunosuppressive agents can lead to OBI reactivation and recurrence of typical serological evidence of infection . The persistence of HBV DNA in the livers of individuals with OBI may provoke a mild but continuing necroinflammation, contributing to the progression of liver disease and increasing the risk of tumorigenesis …”

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confidence: 99%

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Characterization of hepatitis B virus (HBV) preS/S gene mutations in blood donors with occult HBV infection in the Baoji area of North China

et al. 2017

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Characterization of hepatitis B virus (HBV) preS/S gene mutations in blood donors with occult HBV infection in the Baoji area of North China

et al. 2017

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“…The virologic factors associated with increased risk of reactivation include high baseline HBV DNA, HBeAg positivity, and chronic hepatitis B 13–15 . HBV genotype has been increasingly linked to treatment response, disease severity and progression 16, 17 While its association with HBV reactivation is unknown, a few small studies have suggested infection with non-A genotype may be more prone to reactivation 17–19 . The prevalence of HBV genotypes has a variable and divergent worldwide distribution.…”

Section: Risk Factors Of Hbv Reactivationmentioning

confidence: 99%

Hepatitis B Reactivation Associated With Immune Suppressive and Biological Modifier Therapies: Current Concepts, Management Strategies, and Future Directions

2017

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Hepatitis B reactivation associated with immune suppressive and biological therapies is emerging to be an important cause of morbidity and mortality in patients with current or prior exposure to hepatitis B virus infection. The population at risk for HBV reactivation includes those who are either currently infected with HBV or have past exposure to HBV. Since curative and eradicative therapy for HBV is not currently available, there is a large reservoir of individuals at risk for HBV reactivation in the general population. HBV reactivation with its potential consequences is particularly a concern when these people are exposed to either cancer chemotherapy, immunosuppressive or biologic therapies for the management of rheumatologic conditions, malignancies, inflammatory bowel disease, dermatologic conditions, or solid organ or bone marrow transplantation. With the advent of newer and emerging forms of targeted biologic therapies, it has become important to understand the mechanisms whereby certain therapies are more prone to HBV reactivation. The aim of this review is to provide a comprehensive update on the current concepts, risk factors, molecular mechanisms, prevention and management of hepatitis B reactivation. In addition, we provide recommendations for future research in this area.

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“…In addition to rituximab use, other potential factors, including advanced age and male sex, have been reported to be associated with HBV-R (3,7,8). Recently, a relationship between antibodies to hepatitis B surface antigen (anti-HBs) and HBV-R was reported.…”

Section: Introductionmentioning

confidence: 99%

The combination of anti‑HBc and anti‑HBs levels is a useful predictor of the development of chemotherapy‑induced reactivation in lymphoma patients with resolved HBV infection

et al. 2017

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Fatal chemotherapy-induced hepatitis B virus reactivation (HBV-R) is a well-described serious complication observed in patients with lymphoma and resolved HBV infection. The aim of the present study was to determine the predictive factors of the development of chemotherapy-induced HBV-R. A total of 77 consecutive newly diagnosed patients with lymphoma and resolved HBV infection, who received chemotherapy from 2007 through 2015 were analysed retrospectively. Significant predictive factors associated with HBV-R were identified based on the data from these patients. Ten patients developed HBV-R during and following chemotherapy, and two of these 10 patients developed HBV-associated hepatitis flares. There was a significant negative correlation between anti-hepatitis B core (HBc) titres prior to chemotherapy and time to HBV-R (P=0.016, R=−0.732). Univariate and multivariate logistic regression analyses demonstrated that anti-HBc and anti-hepatitis B surface (HBs) titres at baseline were significant predictive factors for HBV-R. In addition, patients with high anti-HBc titres at baseline (above 10 S/CO) were significantly more likely to experience HBV-R than patients with low anti-HBc and high anti-HBs titres (above 28 mIU/ml), who did not experience complete reactivation (P<0.0001). Furthermore, patients with low anti-HBs titres were significantly more likely to experience HBV-R than those with high anti-HBs titres (P=0.031). All HBV-R episodes among the patients with high anti-HBc titres occurred within 3 months following the initiation of chemotherapy. The combination of anti-HBc and anti-HBs titres, as opposed to either titre alone, at baseline in patients with lymphoma may serve as a surrogate marker for the occurrence of HBV-R under the influence of chemotherapy.

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Clinical characteristics and molecular analysis of hepatitis B virus reactivation in hepatitis B surface antigen-negative patients during or after immunosuppressive or cytotoxic chemotherapy

Abstract: Reactivation risk factors included male sex, advanced age, and hematological malignancy. HBV S gene immune-escape mutants were frequently found in the HBsAg-negative reactivation patients during or after immunosuppressive or cytotoxic chemotherapy.

Cited by 24 publications

References 35 publications

Characterization of hepatitis B virus (HBV) preS/S gene mutations in blood donors with occult HBV infection in the Baoji area of North China

Characterization of hepatitis B virus (HBV) preS/S gene mutations in blood donors with occult HBV infection in the Baoji area of North China

Hepatitis B Reactivation Associated With Immune Suppressive and Biological Modifier Therapies: Current Concepts, Management Strategies, and Future Directions

The combination of anti‑HBc and anti‑HBs levels is a useful predictor of the development of chemotherapy‑induced reactivation in lymphoma patients with resolved HBV infection

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