Viral Outcome in Patients with Occult HBV Infection or HCV-Ab Positivity Treated for Lymphoma.
HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivationis strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.
['Guarino|Maria|M|', 'Picardi|Marco|M|', 'Vitello|Anna|A|', 'Pugliese|Novella|N|', 'Rea|Matilde|M|', 'Cossiga|Valentina|V|', 'Pane|Fabrizio|F|', 'Caporaso|Nicola|N|', 'Morisco|Filomena|F|']
D000293:Adolescent D000328:Adult D000368:Aged D000970:Antineoplastic Agents D000998:Antiviral Agents D015415:Biomarkers D005260:Female D016174:Hepacivirus D006509:Hepatitis B D006515:Hepatitis B virus D006526:Hepatitis C D018937:Hepatitis C Antibodies D006689:Hodgkin Disease D006801:Humans D016867:Immunocompromised Host D007558:Italy D008228:Lymphoma, Non-Hodgkin D008297:Male D008875:Middle Aged D012189:Retrospective Studies D000069283:Rituximab D062606:Tertiary Care Centers D014775:Virus Activation D055815:Young Adult
occult HBV infection chemotherapy rituximab HCV infection