P3-162 - Screening for Hepatitis B Virus Carriers and the Incidence of Hepatitis B Reactivation in Patients with Malignant Lymphoma at Our Institution

Abstract

ABSTRACT Background Hepatitis B virus (HBV) reactivation is a rare, but serious complication in cancer patients undergoing chemotherapy, especially those receiving rituximab and steroids. In this prospective study, we screened lymphoma patients for the HBV infection status before the start of chemotherapy, and evaluated the incidence of HBV reactivation after chemotherapy; furthermore, we also evaluated the efficacy of entecavir treatment. Methods Malignant lymphoma patients aged 16 years or over, newly diagnosed at our institution between January 2010 and December 2011, were enrolled. Serologic tests for HBs antigen (HBsAg), HBs antibody (HBsAb), HBc antibody (HBcAb) were carried out in all patients before the start of chemotherapy. In the patients with negative test results, chemotherapy was administered as usual. In the patients, positive for any serum marker of HBV infection, HBV-DNA testing was carried out. If positive, entecavir was started. If negative, HBV-DNA was measured once a month, and if/when the results turned positive, entecavir was started and the chemotherapy continued. Results Among the 103 patients, 50 patients were positive for HBsAg, HBsAb, or HBcAb. Among the patients who were HBsAg(-), HBV-DNA(-), and HBsAb(+) and/or HBcAb(+) (47 patients), two patients (4%) became positive for HBV-DNA and needed entecavir treatment. In three patients who were HBsAg(+) prior to the chemotherapy, chemotherapy was started after administration of entecvir. Among the patients who needed entecavir (five patients), none developed fulminant hepatitis, and HBV-DNA test became negative within 2 months of entecavir administration. Conclusions The incidence of HBV(+) patients at our institution was high as compared with that in previous reports from other area in Japan. The rate of and risk factors (male, HBsAb negative) for HBV reactivation were comparable with those reported previously. In patients who became HBV-DNA-positive, entecavir administration effectively prevented fulminant hepatitis.