Abstract It is estimated that one third of the world population
has been in contact with the hepatitis B virus (HBV)
with a prevalence that varies according to geographic area.
This prevalence is more prevalent among patients with neoplasic
disease. Thus, the risk of viral reactivation of hepatitis
B virus during or after chemotherapy is a clinical problem
requiring special attention. Reactivation is defined by a
significant increase in viral replication in patients with inactive
or “resolved” hepatitis B, often accompanied by an
increase in serum transaminase levels. The consequences
of HBV reactivation range from an asymptomatic hepatitis
to a fulminant hepatic failure and death. HBV reactivation
also leads to premature termination of chemotherapy or
delay in treatment schedules. Thus, HBV serology (HBsAg,
anti-HBc, anti-HBs) is recommended for all patients receiving
chemotherapy. Patients with HBsAg and/or HBV DNA
positive(s) should receive prophylaxis for HBV reactivation.
This preemptive treatment, based on nucleosides/nucleotides
analogues, has proved its effectiveness in reducing virus
reactivation and mortality. Patients HBsAg negative/anti-
HBc positive, receiving no intensive immunosuppressive
therapy, close monitoring of transaminases and HBV DNA
should be established. Antiviral therapy may be started when
HBV reactivation is confirmed. When patients have HBsAg,
anti-HBc and anti-HBs negatives, anti-HBV vaccination
should be established before the introduction of chemotherapy
when possible. A multidisciplinary approach involving
at least an oncologist and a hepatologist is still needed for
better management of these patients
| Référence | 2933 |
| Année | 2013 |
| Type | Article |
| Lien document | |
| Lien externe | https://link.springer.com/article/10.1007/s12558-013-0299-4 |
| Disciplines associées | Oncologie Médicale |
| Auteur | El mekkaoui A |
| Auteurs associés | Benbrahim Z, El mesbahi O, Ibrahimi A, Aqodad N |
| Discipline | Gastroentérologie |
| Revue | Journal Africain du Cancer |
| Référence Revue | 6( 1) 47–53 |
