Hepatitis B Reactivation Rate Is Higher Undergoing Some Cytotoxic Chemotherapy in Patients with Solid Tumors: A Large Retrospective Study

Chemotherapy. 2018;63(5):247-252. doi: 10.1159/000489789. Epub 2018 Nov 8.

Abstract

Objective: The reactivation rate of chronic hepatitis B virus infection in cancer patients and chemotherapy regimens thought to be associated with hepatitis reactivation were investigated.

Patients and methods: In all, 3,890 cancer patients were included in this study. Mortality rates, chemotherapy regimens, cancer types, number of positive hepatitis serology and reactivation rates were obtained.

Results: Only 354 patients had positive hepatitis serology results (HBsAg+). Twenty-four patients (6.7%) with HBsAg positive serology had reactivation. In patients with hepatitis reactivation, the rates of usage of 5-fluorouracil (5-FU), cisplatin, cyclophosphamide, doxorubicin, steroid, rituximab, and vincristine were found to be significantly higher than corresponding rates in patients with positive hepatitis serology results but without hepatitis reactivation (p < 0.05 for all).

Conclusion: Increased reactivation rates were detected with usage of 5-FU, cisplatin, cyclophosphamide, doxorubicin, steroid, rituximab, and vincristine.

Keywords: Chemotherapy; Hepatitis B; Hepatitis reactivation; Lymphoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • DNA, Viral / genetics
  • DNA, Viral / metabolism
  • Doxorubicin / administration & dosage
  • Doxorubicin / adverse effects
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / adverse effects
  • Hepatitis B / complications
  • Hepatitis B / pathology*
  • Hepatitis B / virology
  • Hepatitis B Surface Antigens / blood
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / drug therapy*
  • Retrospective Studies
  • Rituximab / administration & dosage
  • Rituximab / adverse effects
  • Vincristine / administration & dosage
  • Vincristine / adverse effects
  • Virus Activation*
  • Young Adult

Substances

  • DNA, Viral
  • Hepatitis B Surface Antigens
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Fluorouracil