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Hepatitis B virus reactivation in hepatitis B surface antigen seropositive patients with metastatic non-small cell lung cancer receiving cytotoxic chemotherapy: the efficacy of preemptive lamivudine and identification of risk factors

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Abstract

Little is known about the likelihood and degree of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg) seropositive patients with disseminated non-small cell lung cancer (NSCLC) receiving chemotherapy. Between January 2003 and December 2013, all HBsAg seropositive patients with metastatic NSCLC receiving cytotoxic chemotherapy were retrospectively evaluated. The morbidity and mortality of HBV reactivation, risk factors associated with reactivation, as well as the efficacy of preemptive lamivudine were investigated. Of 258 patients who were eligible for the present study, 176 were treated without antiviral prophylaxis and 82 received preemptive lamivudine. Patients without lamivudine prophylaxis had a significantly higher prevalence of HBV reactivation (19.3 vs 6.1 %, p = 0.006) and severe hepatitis attributable to reactivation (11.8 vs 3.7 %, p = 0.034) than those with preemptive lamivudine. However, no significant difference in mortality due to reactivation was noted between patients with or without prophylactic lamivudine (0 vs 2.3 %, p = 0.310). Furthermore, patients who developed HBV reactivation were indentified to have a higher rate of HBeAg seropositivity (74.4 vs 43.4 %, p < 0.001), serum HBV-DNA level of 104 copies/ml or greater (76.9 vs 47.9 %, p = 0.001), coexisting liver metastasis (50.0 vs 40.6 %, p = 0.033) and treatment with more than 4 cycles of chemotherapy (56.4 vs 39.3 %, p = 0.046) than those who did not experienced reactivation. The current study has demonstrated that preemptive lamivudine significantly reduced the prevalence of HBV reactivation in HBsAg seropositive patients with metastatic NSCLC receiving systemic chemotherapy.

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Authors and Affiliations

  1. Department of Medical Oncology, Zhongshan Hospital of Sun Yat-sen University, Zhongshan City People’s Hospital, Zhongshan, People’s Republic of China

    Gui-Nan Lin, Jie-Wen Peng & Jian-jun Xiao

  2. Department of Clinical Oncology, Jiangmen Hospital of Sun Yat-sen University, Jiangmen City Central Hospital, Jiangmen, People’s Republic of China

    Dong-Ying Liu

  3. State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China

    Zhong-Jun Xia

  4. Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People’s Republic of China

    Zhong-Jun Xia

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  1. Gui-Nan Lin
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  2. Jie-Wen Peng
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  4. Dong-Ying Liu
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Correspondence to Zhong-Jun Xia.

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Lin, GN., Peng, JW., Xiao, Jj. et al. Hepatitis B virus reactivation in hepatitis B surface antigen seropositive patients with metastatic non-small cell lung cancer receiving cytotoxic chemotherapy: the efficacy of preemptive lamivudine and identification of risk factors. Med Oncol 31, 119 (2014). https://doi.org/10.1007/s12032-014-0119-0

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  • DOI: https://doi.org/10.1007/s12032-014-0119-0

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