Background: Occult HBV infection (OBI) is defined by the persistence of HBV in the liver without serum HBsAg and HBVDNA. It represents a life-threatening event during immunosuppressive chemotherapies. An OBI occurs in approximately 18% of HBcAb + patients. International guidelines suggest surveillance for HBV markers in immunosuppressed patients. In Non-Hodgkin Lymphoma (NHL), the prevalence of OBI reactivation remains to be established.Methods: In order to determine the prevalence of occult HBV reactivation in a large cohort of patients during chemotherapy for NHL, we analysed 498 NHL patients in a centre of Southern Italy. We evaluated HBV markers, NHL type, treatment type and occurrence of HBV reactivation.Results: Forty % of patients were treated with monoclonal antibodies and 60.3% without. Ninety-six patients were HBcAb+, HBsAg-. HBV reactivation occurred in ten subjects of this subgroup. All of them were successfully treated with Lamivudine. None of the patients experienced liver-related death. The prevalence of OBI reactivation was of 10.42% in HBcAb + HBsAb- patients. This event occurred in 50% of patients treated with mild immunosuppressive therapies. Each reactivation was treated with Lamivudine.Discussion: This report suggests that a strict surveillance is important and cost-effective in HBcAb + HBsAg- NHL patients treated with mild immunosuppressive therapies, in order to detect an occult HBV reactivation.
|Titolo:||Management of the HBV reactivation in isolated HBcAb positive patients affected with Non Hodgkin Lymphoma|
|Parole Chiave:||HBV reactivation; Immunosuppression; Non Hodgkin Lymphoma; Occult HBV infection|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
Settore MED/12 - Gastroenterologia
|Data di pubblicazione:||17-feb-2014|
|Digital Object Identifier (DOI):||10.1186/1471-230X-14-31|
|Appare nelle tipologie:||01 - Articolo su periodico|