Prevention of immunosuppressive therapy or chemotherapy-induced reactivation of hepatitis B virus infection: Joint report of the Intractable Liver Diseases Study Group of Japan and the Japanese Study Group of the Standard Antiviral Therapy for Viral Hepatitis

博仁, 坪内; 博光, 熊田; 研道, 清澤; 智, 持田; 功, 坂井田; 榮司, 田中; 隆文, 市田; 雅史, 溝上; 一幸, 鈴木; 眞彰, 與芝; 久隆, 森脇; 紀文, 日比; 紀夫, 林; 典宏, 國土; 知雄, 藤澤; 大海, 石橋; 寧彦, 菅原; 弘, 八橋; 章雄, 井戸; 康裕, 滝川; 和明, 井上; 真, 桶谷; 浩文, 宇都; 伸朗, 中山; 隆文, 内木; 慎一郎, 多田; 真一, 木曽; 公士, 矢野; 龍人, 遠藤; 靖人, 田中; 武司, 梅村; 公太郎, 熊谷

doi:10.2957/kanzo.50.38

Cited by 66 publications

(57 citation statements)

References 13 publications

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“…Thus, patients with SLE should be tested for HBV to prevent fulminant liver failure, and HBV core as well as HBV surface antibodies must be assessed in patients who are HBV antigen-negative. Moreover, antiviral drugs should be administered according to the guidelines when HBV is confirmed (19).…”

Section: Discussionmentioning

confidence: 99%

Liver Dysfunction in Patients with Systemic Lupus Erythematosus

et al. 2013

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Objective We aimed to define the clinical features of liver dysfunction in patients with systemic lupus erythematosus (SLE). Methods The frequency and causes of liver dysfunction were examined in 206 patients with SLE. Results Liver dysfunction was evident in 123 (59.7%) of the 206 patients. Liver dysfunction in patients with SLE can be drug-induced (30.9%) or caused by SLE itself (28.5%), fatty liver (17.9%), autoimmune hepatitis (AIH) (4.9%), primary biliary cirrhosis (2.4%), cholangitis (1.6%), alcohol (1.6%) or viral hepatitis (0.8%), and it tends to be mild except when caused by AIH. Values for aminotransferase were significantly increased when AIH was the cause, whereas alkaline phosphatase (ALP) and γ-glutamyl transpeptidase (γ-GTP) were significantly increased when AIH or drugs were the cause. The liver was already dysfunctional at the time of SLE onset in 56 (45.5%) of 123 patients with liver dysfunction. Neurological involvement was more common among patients with than without liver dysfunction, whereas SLE activity and prognosis did not significantly differ between the two groups. Conclusion Liver dysfunction in the presence of SLE can be caused by many factors, but when extant at the time of SLE onset, either SLE itself or drugs can be the cause. Autoimmune hepatitis should be considered when liver dysfunction is relatively severe.

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Section: Discussionmentioning

confidence: 99%

Liver Dysfunction in Patients with Systemic Lupus Erythematosus

et al. 2013

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“…For HBsAg-positive patients undergoing systemic chemotherapy, prophylaxis with antiviral drugs is essential, as recommended by the latest American and Japanese guidelines [52,53]. Antiviral drugs should also be administered to HBsAg-negative but HBV-DNA-positive patients who are potentially at an even greater risk for HBV reactivation.…”

Section: Management Of Hbv Reactivation Following Systemic Chemotherapymentioning

confidence: 98%

“…Nonetheless, an early diagnosis of HBV reactivation is critical to enable early initiation of active antiviral therapy. Preemptive therapy guided by serial HBV-DNA monitoring (monthly during and after chemotherapy for at least 1 year) is a reasonable strategy recommended by the latest Japanese guidelines [53]. If HBV-DNA becomes detectable, antiviral therapy should be started as soon as possible.…”

Section: Management Of Hbv Reactivation Following Systemic Chemotherapymentioning

confidence: 99%

Reactivation of hepatitis B virus following rituximab-plus-steroid combination chemotherapy

et al. 2010

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Reactivation of hepatitis B virus (HBV) has been reported as a fatal complication following systemic chemotherapy or other immunosuppressive therapy. The risk of HBV reactivation differs according to both the patient's HBV infection status prior to systemic chemotherapy and the degree of immunosuppression due to chemotherapy. For establishing an optimal strategy for hepatitis prevention and treatment, it is necessary to understand the characteristics, the clinical course and the risk factors for HBV reactivation and to recognize the difference between hepatitis B surface antigen (HBsAg)-positive and -negative patients with HBV reactivation. Among the important viral risk factors, HBV-DNA level and HBV-related serum markers have been reported to be associated with HBV reactivation in addition to cccDNA, genotypes and gene mutations. Rituximab-plus-steroid combination chemotherapy has recently been identified as a host risk factor for HBV reactivation in hepatitis B core antibody (anti-HBc)-positive and/or hepatitis B surface antibody (anti-HBs) positive--but nonetheless HBsAg-negative--lymphoma patients. For these patients with resolved hepatitis B, preemptive therapy guided by serial HBV-DNA monitoring is a reasonable strategy to enable early diagnosis of HBV reactivation and initiation of antiviral therapy. In this review, we summarize the characteristics of HBV reactivation following rituximab-plus-steroid combination chemotherapy, mainly in HBsAg-negative lymphoma patients, and propose a strategy for managing HBV reactivation.

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“…Guidelines for the prevention of immunosuppressive therapy or chemotherapy-induced reactivation of HBV infection have been announced (48), but the following issues should be noted: (i) patients who are HBsAg-negative with HBcAb and/or HBsAb positivity are regarded as a high-risk group, but the frequency of HBV reactivation, the types of anticancer drugs and the cancers that facilitate HBV reactivation, the clinical features of HBV reactivation and the optimal method of management etc. have not been sufficiently elucidated.…”

Section: Problems Regarding Hbv Reactivationmentioning

confidence: 99%

Reactivation of Hepatitis B Virus in Patients Receiving Chemotherapy

Ikeda

2012

Japanese Journal of Clinical Oncology

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In patients undergoing chemotherapy for the treatment of malignant disease, the reactivation of hepatitis B virus in hepatitis B surface antigen-positive patients has been frequently reported. However, activation has also been reported in hepatitis B surface antigen-negative patients who test positive for hepatitis B core antibody and/or hepatitis B surface antibody, who were thought to have had transient infections and to have been cured. Reactivation has often been reported in patients receiving rituximab-containing regimens and has attracted a lot of attention in recent years. In Japan, 1 -3% of patients undergoing chemotherapy are hepatitis B surface antigen-positive, and 20 -25% of patients are hepatitis B surface antigen-negative with hepatitis B core antibody and/or hepatitis B surface antibody positivity; therefore, about one out of every four patients undergoing chemotherapy may be at risk for the reactivation of hepatitis B virus. In most of the guidelines for hepatitis B virus reactivation, the prophylactic administration of an antiviral drug in hepatitis B surface antigen-positive patients is recommended, and periodic monitoring of hepatitis B virus DNA and the deferred pre-emptive administration of an antiviral drug after conversion to hepatitis B virus DNA positivity are recommended in hepatitis B surface antigen-negative patients who are hepatitis B core antibody-positive and/or hepatitis B surface antibody-positive when chemotherapy has been scheduled. However, numerous issues regarding hepatitis B virus reactivation, including the frequency, the types of anticancer drugs, the cancers that facilitate hepatitis B virus reactivation and the optimal method of management, etc., have not been fully clarified. A variety of well-designed prospective studies are currently under way in both Japan and abroad, and strong evidence of hepatitis B virus reactivation following chemotherapy is anticipated in the future.

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Prevention of immunosuppressive therapy or chemotherapy-induced reactivation of hepatitis B virus infection: Joint report of the Intractable Liver Diseases Study Group of Japan and the Japanese Study Group of the Standard Antiviral Therapy for Viral Hepatitis

Cited by 66 publications

References 13 publications

Liver Dysfunction in Patients with Systemic Lupus Erythematosus

Liver Dysfunction in Patients with Systemic Lupus Erythematosus

Reactivation of hepatitis B virus following rituximab-plus-steroid combination chemotherapy

Reactivation of Hepatitis B Virus in Patients Receiving Chemotherapy

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