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Annals of Oncology 12:123-129, 2001
© 2001 European Society for Medical Oncology

other

Reactivation of chronic hepatitis B infection following intensive chemotherapy and successful treatment with lamivudine: A case report and review of the literature

M. Wasif Saif, R. F. Little, J. M. Hamilton, C. J. Allegra and W. H. Wilson

National Cancer Institute Bethesda, Maryland, USA

M Wasif Saif, MD Medicine Branch, NCI National Naval Medical Center. Building 8. Room 5101 8901 Wisconsin Avenue Bethesda, MD 20889 USA E-mail saifw{at}mail.nih.gov

BACKGROUND: Hepatitus B virus reactivation has been reported in cancer patients following administration of chemotherapy or immunosuppressive therapy and may result in liver damage of varying degrees of severity Although treatment is supportive in nature, lamivudine, a nucleoside analogue has been found to suppress HBV replication as evidenced by reports of 13 cases in the medical literature

PATIENTS AND METHODS: We report a patient who achieved a successful outcome with lamivudine following reactivation of HBV during combination chemotherapy for non-Hodgkin's lymphoma, and provide a brief overview of the literature including the 13 published case reports

RESULTS: Lamivudine therapy resulted in clinical improvement as well as in normalization of liver function tests and coagulation profile.

CONCLUSIONS: Lamivudine has been found to suppress HBV replication manifested both by histology and serum HBV-DNA levels in chronic carriers of HBV who developed reactivation of hepatic disease following chemotherapy Physicians caring for such patients should be able to recognize this clinical challenge, and lamivudine should be considered.

chemotherapy,, chronic hepatitis B,, corticosteroids,, fulminant hepatitis,, immunosuppression,, interferon., lamivudine (3TC),, ‘rebound effect’,, plasma exchange


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