Management of the HBV reactivation in isolated HBcAb positive patients affected with Non Hodgkin Lymphoma

Mario Masarone, Amalia De Renzo, Vincenzo La Mura, Ferdinando C. Sasso, Marco Romano, Giuseppe Signoriello, Valerio Rosato, Fabiana Perna, Fabrizio Pane, Marcello Persico

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article number31
JournalBMC Gastroenterology
Volume14
Issue number1
DOIs
Publication statusPublished - Feb 17 2014

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Non-Hodgkin's Lymphoma
Immunosuppressive Agents
Hepatitis B Surface Antigens
Lamivudine
Infection
Drug Therapy
Liver
Italy
Therapeutics
Monoclonal Antibodies
Guidelines
Costs and Cost Analysis
Serum

Keywords

  • HBV reactivation
  • Immunosuppression
  • Non Hodgkin Lymphoma
  • Occult HBV infection

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Management of the HBV reactivation in isolated HBcAb positive patients affected with Non Hodgkin Lymphoma. / Masarone, Mario; De Renzo, Amalia; La Mura, Vincenzo; Sasso, Ferdinando C.; Romano, Marco; Signoriello, Giuseppe; Rosato, Valerio; Perna, Fabiana; Pane, Fabrizio; Persico, Marcello.

In: BMC Gastroenterology, Vol. 14, No. 1, 31, 17.02.2014.

Research output: Contribution to journalArticle

Masarone, M, De Renzo, A, La Mura, V, Sasso, FC, Romano, M, Signoriello, G, Rosato, V, Perna, F, Pane, F & Persico, M 2014, 'Management of the HBV reactivation in isolated HBcAb positive patients affected with Non Hodgkin Lymphoma', BMC Gastroenterology, vol. 14, no. 1, 31. https://doi.org/10.1186/1471-230X-14-31
Masarone, Mario ; De Renzo, Amalia ; La Mura, Vincenzo ; Sasso, Ferdinando C. ; Romano, Marco ; Signoriello, Giuseppe ; Rosato, Valerio ; Perna, Fabiana ; Pane, Fabrizio ; Persico, Marcello. / Management of the HBV reactivation in isolated HBcAb positive patients affected with Non Hodgkin Lymphoma. In: BMC Gastroenterology. 2014 ; Vol. 14, No. 1.
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AU - Romano, Marco

AU - Signoriello, Giuseppe

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AB - 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.

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