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Hepatitis B Virus Reactivation Risk Varies with Different Chemotherapy Regimens Commonly Used in Solid Tumours

Overview
Journal Br J Cancer
Specialty Oncology
Date 2013 May 9
PMID 23652302
Citations 25
Authors
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Abstract

Background: Hepatitis B virus (HBV) reactivation may occur with chemotherapy and has significant morbidity and mortality. The United States Centre for Disease Control and Prevention recommends pre-chemotherapy hepatitis B screening for all cancer patients, while the American Society of Clinical Oncology finds that there is insufficient evidence currently to support such a recommendation. Apart from anthracyclines, HBV reactivation rates from other commonly used chemotherapy regimens in solid tumours are not well described.

Methods: We compared HBV reactivation risk in patients receiving several commonly used chemotherapy regimens for solid tumours associated with different immunosuppression risk at a tertiary cancer centre in an HBV endemic region.

Results: A total of 1149 patients were identified, including 434, 196, 245 and 274, respectively, who received doxorubicin-based, oxaliplatin- or irinotecan-based, carboplatin/gemcitabine, and capecitabine chemotherapy. HBV screening rate was 39% overall. Thirty out of 448 (7%) screened patients were HBsAg positive and 28 out of 30 received prophylactic antiviral therapy with no reactivation. Three out of 1149 patients overall (0.3%) developed HBV reactivation, all from the unscreened doxorubicin group (3 out of 214, 1.4%). No unscreened patients (0 out of 487) in the other three treatment groups developed reactivation (P<0.001).

Conclusion: Not all chemotherapy regimens result in HBV reactivation. Routine hepatitis B screening for low- or moderate-risk regimens may not be warranted.

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References
1.
Dai M, Wu P, Shyu R, Lu J, Chao T . Hepatitis B virus reactivation in breast cancer patients undergoing cytotoxic chemotherapy and the role of preemptive lamivudine administration. Liver Int. 2004; 24(6):540-6. DOI: 10.1111/j.1478-3231.2004.0964.x. View

2.
Jones S, Savin M, Holmes F, OShaughnessy J, Blum J, Vukelja S . Phase III trial comparing doxorubicin plus cyclophosphamide with docetaxel plus cyclophosphamide as adjuvant therapy for operable breast cancer. J Clin Oncol. 2006; 24(34):5381-7. DOI: 10.1200/JCO.2006.06.5391. View

3.
Hsu C, Hsu H, Chen H, Gao M, Yeh P, Chen P . Doxorubicin activates hepatitis B virus (HBV) replication in HBV-harboring hepatoblastoma cells. A possible novel mechanism of HBV reactivation in HBV carriers receiving systemic chemotherapy. Anticancer Res. 2004; 24(5A):3035-40. View

4.
Lok A, McMahon B . Chronic hepatitis B. Hepatology. 2007; 45(2):507-39. DOI: 10.1002/hep.21513. View

5.
Loomba R, Rowley A, Wesley R, Liang T, Hoofnagle J, Pucino F . Systematic review: the effect of preventive lamivudine on hepatitis B reactivation during chemotherapy. Ann Intern Med. 2008; 148(7):519-28. PMC: 2729097. DOI: 10.7326/0003-4819-148-7-200804010-00008. View