Incidence and Prevalence of Hepatitis B Reactivation in Patients Receiving Chemotherapy for Diffuse Large B-cell Lymphoma
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Abstract
Objectives: Reactivation of hepatitis B virus (HBV) infection is a serious complication in patients with Diffuse large B-cell lymphoma (DLBCL) receiving chemotherapy, especially Anthracycline, or monoclonal Anti-CD20 regimen such as Rituximab. The objectives of this study were to determine the incidence and prevalence of HBV reactivation in patients receiving chemotherapy for DLBCL and to find out factors affecting HBV reactivation. The results of this study could aid development of patient care to reduce rates of HBV reactivation after chemotherapy in the future.
Methods: This was a retrospective descriptive study in patients receiving chemotherapy for DLBCL between January 2011 and December 2015 at the Department of Medicine, Faculty of Medicine, Vajira Hospital.
Results: Among 84 patients with DLBCL, 37 (44%) were low risk for HBV reactivation, 47 (56%) were moderate to high risk; 19 patients (40.4%) received antiviral prophylaxis prior to chemotherapy. 6 patients developed HBV reactivation in this study: the incidence of HBV reactivation was 12.8% in 5 years and prevalence was 7.1%. After statistical analysis, significant factors affecting increased risk of HBV reactivation were HBsAg-positive (P=0.014) and bone marrow invasion by lymphoma (P=0.035). The factor affecting decreased risk of HBV reactivation was Anti-HBs-positive (P=0.022).
Conclusion: The incidence of HBV reactivation after receiving chemotherapy for DLBCL is higher than previous studies even with proper antiviral prophylaxis, which may be due to antiviral resistance, especially to Lamivudine. A significant factor affecting risk of HBV reactivation is HBsAg-positive; however, being Anti-HBs-positive decreases the risk of HBV reactivation.
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