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fiogf49gjkf04 De novo Hepatitis B virus-related hepatitis after chemotherapy results in high morbidity and mortality.
Dr Chee-Kin Hui and colleagues from China evaluated the clinical course of de novo Hepatitis B-related hepatitis after chemotherapy.
The investigative team followed up 244 consecutive Hepatitis B surface antigen-negative lymphoma patients treated with chemotherapy for a median of 12 months.
Serially collected serum samples were analyzed for hepatitis, serum Hepatitis B DNA, and Hepatitis B-antigen seroreversion.
The investigators found that 3% developed de novo Hepatitis B-related hepatitis.  | | A 100-fold increase in Hep B DNA preceded de novo Hep B-related hepatitis by 18 weeks | | Gastroenterology |
A 100-fold increase in serum Hepatitis B DNA preceded de novo Hepatitis B-related hepatitis by a median of 18 weeks.
The team noted that all 8 patients had normal serum alanine aminotransaminase level when the 100-fold increase in serum Hepatitis B DNA occurred.
Patients with de novo Hepatitis B-related hepatitis were more likely to have occult Hepatitis B infection before chemotherapy.
Direct sequencing results showed that these 8 patients had de novo Hepatitis B-related hepatitis from reactivation of occult Hepatitis B infection.
The investigators found that 38% patients with de novo Hepatitis B-related hepatitis had developed fulminant hepatic failure.
The team noted that 3% of patients without de novo Hepatitis B-related hepatitis developed fulminant hepatic failure.
On multivariate Cox analysis, de novo Hepatitis B-related hepatitis was independently associated with a higher risk of fulminant hepatic failure.
Dr Hui's team commented, “Close surveillance for a 100-fold increase in Hepatitis B DNA is recommended for Hepatitis B antigen-negative patients treated with chemotherapy so that early commencement of antiviral therapy can be initiated before the occurrence of de novo Hepatitis B-related hepatitis.”
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