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Zachou K, Sarantopoulos A, Gatselis NK, et al. Hepatitis B virus reactivation in hepatitis B virus surface antigen negative patients receiving immunosuppression: A hidden threat. World J Hepatol. 2013;5(7):387-92doi: 10.4254/wjh.v5.i7.387.
Zachou, K., Sarantopoulos, A., Gatselis, N. K., Vassiliadis, T., Gabeta, S., Stefos, A., Saitis, A., Boura, P., & Dalekos, G. N. (2013). Hepatitis B virus reactivation in hepatitis B virus surface antigen negative patients receiving immunosuppression: A hidden threat. World journal of hepatology, 5(7), 387-92. https://doi.org/10.4254/wjh.v5.i7.387
Zachou, Kalliopi, et al. "Hepatitis B virus reactivation in hepatitis B virus surface antigen negative patients receiving immunosuppression: A hidden threat." World journal of hepatology vol. 5,7 (2013): 387-92. doi: https://doi.org/10.4254/wjh.v5.i7.387
Zachou K, Sarantopoulos A, Gatselis NK, Vassiliadis T, Gabeta S, Stefos A, Saitis A, Boura P, Dalekos GN. Hepatitis B virus reactivation in hepatitis B virus surface antigen negative patients receiving immunosuppression: A hidden threat. World J Hepatol. 2013 Jul 27;5(7):387-92. doi: 10.4254/wjh.v5.i7.387. PMID: 23898372; PMCID: PMC3724967.
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World J Hepatol. 2013 Jul 27;5(7):387-92. doi: 10.4254/wjh.v5.i7.387.

Hepatitis B virus reactivation in hepatitis B virus surface antigen negative patients receiving immunosuppression: A hidden threat.

World journal of hepatology

Kalliopi Zachou, Alexandros Sarantopoulos, Nikolaos K Gatselis, Themistoklis Vassiliadis, Stella Gabeta, Aggelos Stefos, Asterios Saitis, Panagiota Boura, George N Dalekos

Affiliations

  1. Kalliopi Zachou, Nikolaos K Gatselis, Stella Gabeta, Aggelos Stefos, Asterios Saitis, George N Dalekos, Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, 41110 Larissa, Greece.

PMID: 23898372 PMCID: PMC3724967 DOI: 10.4254/wjh.v5.i7.387

Abstract

AIM: To present the characteristics and the course of a series of anti-hepatitis B virus core antibody (HBc) antibody positive patients, who experienced hepatitis B virus (HBV) reactivation after immunosuppression.

METHODS: We retrospectively evaluated in our tertiary centers the medical records of hepatitis B virus surface antigen (HBsAg) negative patients who suffered from HBV reactivation after chemotherapy or immunosuppression during a 3-year period (2009-2011). Accordingly, the clinical, laboratory and virological characteristics of 10 anti-HBc (+) anti-HBs (-)/HBsAg (-) and 4 anti-HBc (+)/antiHBs (+)/HBsAg (-) patients, who developed HBV reactivation after the initiation of chemotherapy or immunosuppressive treatment were analyzed. Quantitative determination of HBV DNA during reactivation was performed in all cases by a quantitative real time polymerase chain reaction kit (COBAS Taqman HBV Test; cut-off of detection: 6 IU/mL).

RESULTS: Twelve out of 14 patients were males; median age 74.5 years. In 71.4% of them the primary diagnosis was hematologic malignancy; 78.6% had received rituximab (R) as part of the immunosuppressive regimen. The median time from last chemotherapy schedule till HBV reactivation for 10 out of 11 patients who received R was 3 (range 2-17) mo. Three patients (21.4%) deteriorated, manifesting ascites and hepatic encephalopathy and 2 (14.3%) of them died due to liver failure.

CONCLUSION: HBsAg-negative anti-HBc antibody positive patients can develop HBV reactivation even 2 years after stopping immunosuppression, whereas prompt antiviral treatment on diagnosis of reactivation can be lifesaving.

Keywords: Anti-hepatitis B virus core antibody positivity; Hepatitis B; Immunosuppression; Occult hepatitis B virus infection; Rituximab

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