Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia
Hepatitis B virus (HBV) reactivation is an increasingly recognized cause of morbidity and mortality in patients undergoing chemotherapy. In haematology, the risk of reactivation of B hepatitis among HBsAg-positive patients has been documented; therefore, use of lamivudine prophylaxis is recommended...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Case Reports in Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2011/258791 |
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| author | Federica Toscanini Pasqualina De Leo Giuseppe Calcagno Federica Malfatti Alessandro Grasso Marco Anselmo |
| author_facet | Federica Toscanini Pasqualina De Leo Giuseppe Calcagno Federica Malfatti Alessandro Grasso Marco Anselmo |
| author_sort | Federica Toscanini |
| collection | DOAJ |
| description | Hepatitis B virus (HBV) reactivation is an increasingly recognized cause of morbidity and mortality in patients undergoing chemotherapy. In haematology, the risk of reactivation of B hepatitis among HBsAg-positive patients has been documented; therefore, use of lamivudine prophylaxis is recommended before starting chemotherapy. Differently, for HBsAg-negative patients with markers of previous HBV infection (i.e., presence of isolated anti-HBc positivity) (anticore patients) management strategies are not univocal. We describe a rare case of HBV reactivation in an anticore patient after fludarabine therapy for chronic lymphocytic leukaemia. The patient fully recovered after a 6-month course of lamivudine with persistent HBV-DNA clearance and loss of HBsAg. The most important feature of this case is that fludarabine alone infrequently determines HBV reactivation, especially in anticore patients. Therefore, we suggest that patients candidates to receive fludarabine therapy should be considered for lamivudine prophylaxis, not only if HBsAg-positive, but even if anticore-positive only. |
| format | Article |
| id | doaj-art-83ae434365184f20a804bb630c1dbcc8 |
| institution | Kabale University |
| issn | 2090-6587 2090-6595 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hepatology |
| spelling | doaj-art-83ae434365184f20a804bb630c1dbcc82025-02-03T06:11:58ZengWileyCase Reports in Hepatology2090-65872090-65952011-01-01201110.1155/2011/258791258791Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic LeukaemiaFederica Toscanini0Pasqualina De Leo1Giuseppe Calcagno2Federica Malfatti3Alessandro Grasso4Marco Anselmo5Department of Infectious Diseases, San Paolo Hospital, Via Genova 20, 17100 Savona, ItalyDepartment of Infectious Diseases, San Paolo Hospital, Via Genova 20, 17100 Savona, ItalyDepartment of Infectious Diseases, San Paolo Hospital, Via Genova 20, 17100 Savona, ItalyDepartment of Internal Medicine and Gastroenterology, San Paolo Hospital, 17100 Savona, ItalyDepartment of Internal Medicine and Gastroenterology, San Paolo Hospital, 17100 Savona, ItalyDepartment of Infectious Diseases, San Paolo Hospital, Via Genova 20, 17100 Savona, ItalyHepatitis B virus (HBV) reactivation is an increasingly recognized cause of morbidity and mortality in patients undergoing chemotherapy. In haematology, the risk of reactivation of B hepatitis among HBsAg-positive patients has been documented; therefore, use of lamivudine prophylaxis is recommended before starting chemotherapy. Differently, for HBsAg-negative patients with markers of previous HBV infection (i.e., presence of isolated anti-HBc positivity) (anticore patients) management strategies are not univocal. We describe a rare case of HBV reactivation in an anticore patient after fludarabine therapy for chronic lymphocytic leukaemia. The patient fully recovered after a 6-month course of lamivudine with persistent HBV-DNA clearance and loss of HBsAg. The most important feature of this case is that fludarabine alone infrequently determines HBV reactivation, especially in anticore patients. Therefore, we suggest that patients candidates to receive fludarabine therapy should be considered for lamivudine prophylaxis, not only if HBsAg-positive, but even if anticore-positive only.http://dx.doi.org/10.1155/2011/258791 |
| spellingShingle | Federica Toscanini Pasqualina De Leo Giuseppe Calcagno Federica Malfatti Alessandro Grasso Marco Anselmo Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia Case Reports in Hepatology |
| title | Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia |
| title_full | Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia |
| title_fullStr | Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia |
| title_full_unstemmed | Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia |
| title_short | Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia |
| title_sort | hepatitis b reactivation in a hbsag negative hbcab positive patient receiving fludarabine for the treatment of chronic lymphocytic leukaemia |
| url | http://dx.doi.org/10.1155/2011/258791 |
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