Successful Treatment with Entecavir for Reactivation of Hepatitis B Virus Following Systemic Chemotherapy in a Hepatitis B Surface Antigen-negative Patient with Colorectal Cancer

Abstract

Reactivation of hepatitis B virus (HBV) has recently been reported as a fatal complication in patients undergoing cytotoxic chemotherapy. We herein describe a case of reactivation in a 76-year-old man who had undergone pelvic exenteration for colorectal cancer (CRC). He was treated with a modified FOLFOX6 chemotherapy regimen after the operation. Thirteen months later, his laboratory data showed severe liver dysfunction. His hepatitis B surface antigen (HBsAg) test was positive, and his HBV-DNA level was elevated. We diagnosed the patient with HBV reactivation as his HBsAg test was negative before starting chemotherapy. His liver dysfunction improved after administration of entecavir. This is the first report describing HBV reactivation following chemotherapy for an HBsAg-negative CRC patient.

Complete response with fluorouracil and irinotecan with a BRAF^V600E and EGFR inhibitor in BRAF-mutated metastatic colorectal cancer: a case report

“…Furthermore, hepatitis B in patients with CRC is reported to reduce the risk of liver metastasis with simultaneous increase in extrahepatic metastasis 29. Furthermore, chemotherapy is reported to reactivate hepatitis B in patients with CRC, who were HBsAg-negative previously 30. Hence, telbivudine (600 mg qd) was administered throughout the chemotherapeutic period to obtain the optimal effects of the treatment.…”

Postoperative hepatitis B virus reactivation and surgery‐induced immunosuppression in patients with hepatitis B‐related hepatocellular carcinoma

“…This evidence of a link between surgery‐induced immunosuppression and PHR may extend to various types of surgery beyond hepatic resection. Indeed, several studies have reported that PHR can occur following TACE, RFA, or chemotherapies , as well as after partial hepatectomy and organ transplantation . Future studies should explore the link between immunosuppression and PHR in gastrectomy for gastric carcinoma, resection for bowel cancer and other surgeries besides hepatectomy.…”

Hepatitis B reactivation in the setting of chemotherapy and immunosuppression - prevention is better than cure

“…Numerous case reports and series describe death due to liver failure despite the introduction of lamivudine at the onset of HBVr [82][83][84][85][86] . Only a few cases of successful treatment of HBVr with entecavir have been published [87][88][89] .…”