Reactivation of hepatitis B but not hepatitis C in patients with malignant lymphoma and immunosuppressive therapy. A prospective study in 305 patients

Hepatogastroenterology. 1999 Sep-Oct;46(29):2925-30.

Abstract

Backgrounds/aims: The aim of this prospective study was to determine the prevalence of hepatitis B (HBV) and hepatitis C viral (HCV) infection as well as to study the morbidity and mortality of viral reactivations in patients treated with corticosteroid containing chemotherapy.

Methodology: From January 1991 to April 1996, 305 patients admitted for treatment of Hodgkin's disease and non-Hodgkin's lymphoma were tested for HBV, and 181 patients for HCV infection. They were followed-up regularly on a monthly basis with liver biochemistry and viral serology.

Results: The prevalence of HBs antigen and hepatitis C antibody was found to be 3.2% and 16% respectively. There were 9 reactivations of HBV among 8 HBs antigen positive patients (78%), one among 35 HBs antigen negative patients (2.8%) and none in HCV positive patients. In 83% of cases, reactivation was connected to chemotherapy and corticosteroids. The overall death rate of HBV reactivation was 37%; in severe hepatitis it was 60%. All fatal reactivations were in anti-HBe positive patients.

Conclusions: The low prevalence of HCV failed to demonstrate an association between hepatitis C viral infection and lymphoma in Slovenia. Reactivation of HBV infection in HBsAg positive malignant lymphoma patients is a common and often fatal complication of treatment.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects*
  • Adult
  • Aged
  • Female
  • Hepacivirus / drug effects*
  • Hepacivirus / immunology
  • Hepatitis B / chemically induced*
  • Hepatitis B / immunology
  • Hepatitis B virus / drug effects*
  • Hepatitis B virus / immunology
  • Hepatitis C / chemically induced*
  • Hepatitis C / immunology
  • Hodgkin Disease / drug therapy
  • Hodgkin Disease / immunology
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects*
  • Lymphoma / drug therapy*
  • Lymphoma / immunology
  • Lymphoma, B-Cell / drug therapy
  • Lymphoma, B-Cell / immunology
  • Male
  • Middle Aged
  • Opportunistic Infections / chemically induced*
  • Opportunistic Infections / immunology
  • Risk Factors
  • Slovenia
  • Survival Rate
  • Virus Activation / drug effects*

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents