Lamivudine prophylaxis prevents hepatitis B virus reactivation in anti-HBc positive patients under rituximab for non-Hodgkin lymphoma

Alessandro Loglio, Mauro Viganò, Glenda Grossi, Sara Labanca, Maria Goldaniga, Alessandra Pompa, Lucia Farina, Mariagrazia Rumi, Paolo Corradini, Floriana Facchetti, Giovanna Lunghi, Luca Baldini, Pietro Lampertico

Research output: Contribution to journalArticle

Abstract

Backgound: A significant proportion of hepatitis B surface antigen (HBsAg) negative/anti-hepatitis B core antigen (anti-HBc) positive patients with non-Hodgkin lymphoma (NHL) undergoing rituximab-based chemotherapy (R-CT) may suffer hepatitis B virus (HBV) reactivation. Aims: We wanted to assess efficacy and safety of lamivudine (LMV) prophylaxis to prevent this complication. Methods: Eighty-five consecutive HBsAg negative/anti-HBc positive NHL patients (71 years, 100% serum HBV DNA undetectable, 74% anti-HBs positive) received LMV coadministered with R-CT and for 18 months after the end of R-CT. Serum ALT, HBsAg, anti-HBs and HBV DNA were assessed every 4 months during and after end of LMV. Results: During 39 (2–108) months of study period, including 21 months of LMV and 27 additional months after LMV discontinuation, one patient (2%) had HBV reactivation, 31 months after stopping LMV and during administration of new immunosuppressive regimens, without LMV prophylaxis, owing to incomplete oncological response. A 50% decline of anti-HBs titers occurred in 22/63 (35%) patients, including 12 who became anti-HBs seronegative. Five (6%) patients had ALT increase during R-CT but none required R-CT discontinuation. Seventeen (20%) patients died, all for tumour progression. Conclusion: LMV prophylaxis is safe and effective in preventing HBV reactivation in HBsAg negative/anti-HBc positive NHL patients receiving R-CT.

Original languageEnglish
Pages (from-to)419-424
JournalDigestive and Liver Disease
Volume51
Issue number3
DOIs
Publication statusPublished - 2019

Keywords

  • Anti-CD20
  • Chemotherapy
  • HBV
  • Nucleoside analog

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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