Journal
LEUKEMIA & LYMPHOMA
Volume 46, Issue 7, Pages 1085-1089Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/10428190500062932
Keywords
chemotherapy; lymphoma; hepatitis B; reactivation; surface antigen; core antibody
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In the absence of prophylaxis, the reactivation of hepatitis B in oncology patients who are hepatitis B carriers is a well-known and often fatal complication of chemotherapy. The current recommendations in Canada and the USA are that patients who are positive for hepatitis B surface antigen ( HBsAg) receive antiviral prophylaxis prior to chemotherapy. We report a 67-yearold man with B-cell lymphoma who developed hepatitis B reactivation following chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone and rituximab. Pre-chemotherapy, the patient was negative for HBsAg, positive for hepatitis B core antibody ( anti-HBc) and weakly positive for hepatitis B surface antibody. Despite treatment with lamivudine, the patient died of fulminant hepatic failure. Our experience indicates that patients who are negative for HBsAg but positive for anti-HBc are still at risk for reactivation of latent hepatitis B during and after chemotherapy and may be considered for prophylaxis.
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