Retrospective analysis of hepatitis B virus reactivation after rituximab combination chemotherapy in patients with B-cell lymphoma

• DOI: 10.1007/s10330-011-0875-7
• Publication Date: 2011-12-08T16:42:57Z
• Authors: Yun Fan; Chong Luo; Lvhong Luo; Zhiyu Huang; Haifeng Yu
• Keywords: Hepatitis B

The aim of the study was to investigate the reactivations of hepatitis B virus (HBV) after rituximab-containing chemotherapy in patients with B-cell lymphoma with surface antigen of hepatitis B virus (HBsAg)-positive, or hepatitis B core antibody (HBcAb)-positive. A retrospective study of HBV-related markers was performed before and after rituximab-containing treatment in 189 consecutive patients with CD20-positive B-cell lymphoma. Among the 189 non-Hodgkin’s lymphoma (NHL) patients who received rituximab combination chemotherapy, 31 (16.6%) were HBsAg positive and 82 (43.9%) HBsAg negative/HBcAb positive, and 76 were HBsAg and HBcAb negative. Of the 31 HBsAg positive patients, 3 (9.7%) experienced reactivation of HBV. The prevalence of HBV reactivation was 4.0% (1/25) in patients who received prophylactic antiviral treatment and 33.3% (2/6) in those who did not receive prophylactic antiviral treatment (P = 0.032). Prophylactic antiviral treatment decreased the rate of HBV reactivation. Among the 82 HBsAg negative/HBcAb positive patients, 1 (1.2%) experienced HBV reactivation leading to serious hepatitis. Our experience indicates that rituximab-based therapy may cause serious HBV-related complications and even death in HBsAg-positive patients. Preemptive use of antiviral treatment enabled successful management of HBV reactivation. In HBsAg-negative and HBcAb-positive lymphoma patients the prevalence of HBV reactivation is low (1.2%). Close monitoring HBV until at least 6 months after anticancer therapy is required, prophylactic antiviral therapy needs to be evaluated further.