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Tumor Biology

, Volume 34, Issue 2, pp 909–918 | Cite as

An optimized antiviral modification strategy for prevention of hepatitis B reactivation in patients undergoing prophylactic lamivudine and chemotherapy: a pilot study

  • Xiang-Yuan Wu
  • Xing Li
  • Zhan-Hong Chen
  • Jing-Yun Wen
  • Qu Lin
  • Yan-Fang Xing
  • Min Dong
  • Li Wei
  • Tian-Tian Wang
  • Jie Chen
  • Ze-Xiao Lin
  • Xiang-bo Wan
  • Dan-Yun Ruan
  • Xiao-Kun Ma
Research Article

Abstract

In patients receiving prophylactic lamivudine (LAM) and chemotherapy, hepatitis B virus (HBV) reactivation cannot be eliminated without knowing the latent causes and optimal management. In our previous study, virus breakthrough and relapse were highly suspected as potential virologic causes for HBV reactivation. Therefore, we reviewed 24 previous studies and 447 patients who underwent chemotherapy and prophylactic LAM, with an incidence of 7.2 % HBV reactivation. Virus breakthrough and relapse were seldom investigated in these studies. In addition, 72 patients that underwent prophylactic LAM and chemotherapy at our centers were also analyzed. Among them, eight patients developed virus breakthrough, with another nine developing virus relapse after discontinuation of LAM. Eight patients received antiviral modification, which included administration of adefovir for patients with virus breakthrough or resumption of LAM for patients with virus relapse and none of them developed HBV reactivation. In contrast, of the nine patients who did not receive antiviral modification, six developed HBV reactivation and two died. In conclusion, this study demonstrated that virus breakthrough and relapse were the critical causative factors of HBV reactivation in patients receiving chemotherapy and prophylactic LAM. An optimized antiviral modification strategy could effectively prevent HBV reactivation in patients with virus breakthrough or relapse.

Keywords

HBV reactivation Virus breakthrough Virus relapse Modified antiviral strategy Chemotherapy 

Notes

Acknowledgments

This work was supported by the Science and Technology Planning Project of Guangdong Province, 2009B060700024 (to XY Wu), 2011B031800076 (to Q Lin), and 2011B031800014 (to M Dong).

Conflicts of interest

All authors have contributed equally and are in agreement with the content of the manuscript without any potential conflicts of interest.

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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2012

Authors and Affiliations

  • Xiang-Yuan Wu
    • 1
  • Xing Li
    • 1
  • Zhan-Hong Chen
    • 1
  • Jing-Yun Wen
    • 1
  • Qu Lin
    • 1
  • Yan-Fang Xing
    • 2
  • Min Dong
    • 1
  • Li Wei
    • 1
  • Tian-Tian Wang
    • 1
  • Jie Chen
    • 1
  • Ze-Xiao Lin
    • 1
  • Xiang-bo Wan
    • 1
  • Dan-Yun Ruan
    • 1
  • Xiao-Kun Ma
    • 1
  1. 1.Department of Medical OncologyThe Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  2. 2.Department of NephrologyThe Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina

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