Hepatitis B Reactivation in Patients with Hematological and Solid Malignancies: A Retrospective Analysis of Single Center’s Experience

Background: Hepatitis B reactivation might occur in patients with hematological and solid organ malignancies due to immunosuppressive effect of chemotherapy. Methods: Fourteen patients were evaluated retrospectively from their files to discuss the clinical manifestations, management, and avoiding of Hepatitis B reactivation within patients who receive immunosuppressive treatment. Results: These 14 HbsAg positive patients were being followed up and treated via oncological immunosuppressive chemotherapy. The ages of the patients were between 25 and 72. Seven of the patients were male, and the average follow up period for the patients was between 10 and 74 months. TV 0, 5 mg was started for seven of the patients before the chemotherapy and TFV 245 mg to one of the patients. LAM 100 was started for three patients whose basal HBV DNA was low. It has been analyzed that HBV DNA was negative in further observations. In follow up controls, we noticed HBV reactivation at two patients, LAM was given one of them and TFV was given the other one. One patient was applied allogeneic transplantation whose basal liver tests were normal and Hbsag was negative. Hepatitis B reactivation was detected after the first week of therapy. Conclusions: We offer testing in all patients undergoing cancer therapy for hepatitis B, HBsAg, core antibody (anti-HBc total), and anti-HBs before to start cancer therapy. Patients with higher risk of HBV reactivation require antiviral prophylaxis.