Clinical–liver, pancreas, and biliary tractKinetics and Risk of De Novo Hepatitis B Infection in HBsAg–Negative Patients Undergoing Cytotoxic Chemotherapy
Section snippets
Materials and Methods
Two hundred forty-four consecutive HBsAg- and hepatitis C virus (HCV)-negative patients treated for malignant lymphoma with intravenous cytotoxic chemotherapy at the Haematology/Oncology Unit, Queen Mary Hospital, from January 2000 to May 2005, were included in this study. The patients were screened for HBsAg, hepatitis B surface antibody (anti-HBs), anti-HBc (Abbott Laboratories, North Chicago, IL), and anti-HCV with the second-generation enzyme-linked immunosorbent assay (Ortho Diagnostics
Results
Of the 244 patients, 152 (62.3%) were anti-HBc positive. One hundred twenty-one of the 244 patients (49.6%) were both anti-HBc and anti-HBs positive. Twenty-one of the 244 patients (8.6%) were anti-HBs positive but anti-HBc negative. The patients were followed up for a median of 12.4 (range, 0.1–65.0) months. At the time of analysis, 8 of the 244 patients (3.3%) had developed de novo HBV-related hepatitis after chemotherapy. The baseline characteristics of these patients are shown in Table 2.
Discussion
Although it is well established that HBsAg-positive patients are prone to develop HBV reactivation and severe liver dysfunction after chemotherapy, little attention has been paid to patients who developed de novo HBV-related hepatitis after chemotherapy. The discovery that HBV can persist for decades after clinical recovery from acute hepatitis B, despite the presence of serum anti-HBs, has provided us with insights into the pathogenesis of HBV reactivation in patients who are HBsAg negative
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Supported by The Cheng Si-Yuan (China-International) Hepatitis Research Foundation (to C.K.H.) and by a grant from the National Natural Science Investigator Award (to G.K.K.L. and Mr. Heung Chit Kau).
The authors declare that they have no conflict of interest.