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Patients with hematological malignancies and serological signs of prior resolved hepatitis B

World Journal of Gastrointestinal Oncology 2012年第3期4卷 37-45页

作者： Massimo Marignani Elia Gigante Paola Begini alfredo marzano Michela di Fonzo Ilaria Deli Sara Gallina Maria Christina Cox Gianfranco Delle Fave Digestive and Liver Disease Department School of Medicine and Psychology University "Sapienza" Azienda Ospedaliera S. Andrea Via Grottarossa 1035-1039 00189 Rome Italy SCDU of Gastroenterology and Hepatology AO San Giovanni Battista Corso Bramante 88 10125 Torino Italy Haematology Department School of Medicine and Psychology University "Sapienza" Azienda Ospedaliera S. Andrea Via Grottarossa 1035-1039 00189 Rome Italy

Hepatitis B virus (HBV) infection affects a large part of the world population. Within the different virological HBV categories that have been identified, patients with occult HBV infection represent a peculiar group. These individuals harbor a replication competent virus, inhibited in its replicative function. Accordingly, cases of reactivations have been observed in immunosuppressed individuals who lose immunological control over the infection. Patients with hematological malignancies (HM) are treated with intense myeloand immunosuppres-sive chemotherapy regimens which favor HBV reactivation. This event can have severe consequences, such as hepatitis flare, hepatic failure and even death. In addition, it can lead to delays or interruptions of curative treatments, resulting in a decreased disease free and overall survival. In this review, we will examine the event of HBV reactivation in patients with signs of resolved HBV infection undergoing treatment for HM and propose possible management strategies.

关键词： Occult hepatitis B Hematological malignancies Hepatitis B virus Chemotherapy Hepatitis B reactivation

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Hepatitis B in patients with hematological diseases: An update

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World Journal of Hepatology 2017年第25期9卷 1043-1053页

作者： Chiara Coluccio Paola Begini alfredo marzano Adriano Pellicelli Barbara Imperatrice Giulia Anania Gianfranco Delle Fave Massimo Marignani Dig-estive and Liver Diseases Department Sant’Andrea HospitalSchool of Medicine and PsychologySapienza University Division of Gastroenterology and Hepatology San Giovanni Battista Hospital Liver Unit San Camillo Forlanini Hospital

Hepatitis B virus(HBV) reactivation(HBVr) in patients undergoing immunosuppressive therapy is still a hot topic worldwide. Its prevention and management still represents a challenge for specialists dealing with immunosuppressed patients. Aim of this paper is to provide a critical review of the relevant information emerged in the recent literature regarding HBV reactivation following immunosuppressive treatments for oncohematological tumors. A computerized literature search in MEDLINE was performed using appropriate terms arrangement, including English-written literature only or additional relevant articles. Articles published only in abstract form and case reports not giving considerable news were excluded. Clinical manifestation of HBVr can be manifold, ranging from asymptomatic self-limiting anicteric hepatitis to life-threatening fulminant liver failure. In clusters of patients adverse outcomes are potentially predictable. Clinicians should be aware of the inherent risk of HBVr among the different virological categories(active carriers, occult HBV carriers and inactive carriers, the most intriguing category), and classes of immunosuppressive drugs. We recommend that patients undergoing immunosuppressive treatments for hematological malignancies should undergo HBV screening. In case of serological sign(s) of current or past infection with the virus, appropriate therapeutic or preventive strategies are suggested, according to both virological categories, risk of HBVr by immunosuppressive drugsand liver status. Either antiviral drug management and surveillance and pre-emptive approach are examined, commenting the current international recommendations about this debated issue.

关键词： Reactivation Lymphoma Hematology Immunosuppressive therapy Prophylaxis Hepatitis B virus Chemotherapy Occult/active/inactive carrier Entecavir Lamivudine

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