Lamivudine prophylaxis reduces the incidence and severity of hepatitis in hepatitis B virus carriers who receive chemotherapy for lymphoma

Abstract

Objective Metabolic syndrome (MetS) is highly prevalent in rheumatic diseases and is recognized as a new independent cardiovascular risk factor. This study was undertaken to determine the clinical significance of MetS in patients with primary antiphospholipid syndrome (APS). Methods Seventy‐one primary APS patients and 73 age‐ and sex‐matched healthy controls were included. Serum samples were tested for lipid profile, Lp(a), glucose, insulin, thyroid‐stimulating hormone, free T4, erythrocyte sedimentation rate, C‐reactive protein level, and uric acid. MetS was defined by the International Diabetes Federation criteria, and insulin resistance was established using the homeostasis model assessment index. Results The prevalence of MetS was 33.8%, and further comparison between primary APS patients with and without MetS revealed that the former had a higher frequency of arterial events (79.2% versus 42.6%; P = 0.003), angina (29.2% versus 2.1%; P = 0.002), and positive lupus anticoagulant antibody (95.8% versus 76.6%; P = 0.049). In addition, primary APS patients with MetS, as expected, had a higher prevalence of cardiovascular risk factors. On multivariate analysis, only MetS was independently associated with arterial events in primary APS. Conclusion Coexistence of primary APS and MetS seems to identify a subgroup of patients with higher risk of arterial events, suggesting that MetS may aggravate existing endothelial abnormalities of primary APS.

Hepatitis B prophylaxis in patients undergoing chemotherapy for lymphoma: A decision analysis model

“…Recent studies have shown that prophylaxis with lamivudine before the initiation of chemotherapy reduces both the incidence and severity of HBV reactivations. [12][13][14][15][16][17][19][20][21][22][23][24][25][26] However, no studies have investigated the use of prophylactic lamivudine in an economic analysis. In this study, we compared the costs and clinical outcomes of 2 different strategies for chronic hepatitis B carriers undergoing chemotherapy for lymphoma treatment.…”

“…Data from 14 studies published from various parts of the world between 1990 and 2006 that examined HBV reactivation in lymphoma patients undergoing chemotherapy were collected (Table 1). [12][13][14][15][16][17][19][20][21][22][23][24][25][26] Seven of these studies compared the prophylactic use of lamivudine during chemotherapy to the empiric use of the drug, [12][13][14][15][16][17]26 6 studies restricted lamivudine to the treatment of reactivation, [20][21][22][23][24][25] and 1 study examined only the prophylactic use of lamivudine. 19 Lymphoma and Chemotherapy.…”

“…[12][13][14][15][16]19 Those who did not receive prophylaxis but were able to complete chemotherapy uneventfully [12][13][14][15][16]20,22,23 had higher survival rates than those who did not receive prophylaxis and had interruptions in their chemotherapy. [12][13][14][15][16]20,22,23 The cancer-related death rate for patients who did not have hepatitis B viral reactivation was not available from these studies and was assumed to be equal to the cancer death rate in the prophylaxis group of patients who did not have HBV reactivation and were able to complete their scheduled chemotherapy. If HBV reactivation did occur, the mean time to the episode was after the third cycle of chemotherapy.…”

“…11 The use of prophylactic lamivudine can decrease the incidence of HBV reactivation from 30%-80% to 0%-17%. [12][13][14][15][16][17] The aim of this study was to compare the efficacy and costs of 2 management strategies in patients with hepatitis B undergoing chemotherapy: (1) lamivudine prophylaxis and (2) lamivudine use only in patients with evidence of an HBV reactivation. Because lamivudine has been shown to be effective in preventing HBV reactivation, is inexpensive, and is associated with few adverse effects, we believed that the use of lamivudine prophylaxis would be most cost-effective.…”

Hepatitis B Virus Infection in B-Cell Non-Hodgkin’s Lymphoma, and Effect of Entecavir in Prophylactic Antiviral Therapy

“…It leads to 340,000 liver cancer cases and 500,000 to 1.2 million liver-related deaths each year [2] [3]. China is one of the endemic areas of chronic HBV infection, HBV infection is a common disease, and there are approximately 170 million carriers in China [4]. The incidence of Non-Hodgkin's Lymphoma is increasing rapidly in China, with an annual rise of 1% to 4% [5].…”