HEPATITIS B VIRUS REACTIVATION IN PATIENTS UNDERGOING CHEMOIMMUNOTHERAPY FOR HAEMATOLOGICAL MALIGNANCIES
VIOLETA MOLAGIC 1#*, CĂTĂLIN TILIȘCAN 1,2#, CRISTINA POPESCU 1,2, VICTORIA ARAMĂ 1,2#, MIHAELA RĂDULESCU 1,2, ANA MARIA VLĂDĂREANU 2,3, ȘTEFAN SORIN ARAMĂ 1,2
1.“Prof. Dr. Matei Balș” National Institute for Infectious Diseases, 1 Dr. Grozovici Street, Bucharest, Romania
2.“Carol Davila” University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu Street, Bucharest, Romania
3.Haematology Department, University Emergency Hospital Bucharest, 169 Splaiul Independenței Street, Bucharest, Romania
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Hepatitis B virus (HBV) infection continues to be a major global health problem. HBV reactivation has been documented both in HBsAg positive patients and in individuals with occult hepatitis B infection (OBI) - negative for HBsAg but positive for anti-hepatitis B core IgG antibodies (IgG anti-HBc). HBV reactivation has a major clinical significance, especially in patients receiving chemoimmunotherapy for haematological malignancies (HM). We aimed to evaluate clinical and epidemiological patterns of HBV reactivation in the OBI group compared to the HBV reactivation in HBsAg positive patients (non-OBI group) during chemoimmunotherapy for HM. We enrolled 63 patients with HM and at least one serological marker of HBV infection, including 10 patients with OBI. Viral reactivation occurred overall in 29/63 patients (46.2%). In the OBI group, seven patients (70%) had reactivation with HBsAg reverse seroconversion after a mean of 5.5 chemotherapy cycles, compared to 22 patients (41.5%) in the non-OBI group (p = 0.0097). All patients with viral reactivation were treated with antiviral therapy (entecavir) with a favourable outcome. No deaths occurred due to hepatic failure and the risk of reactivation was not correlated with age, sex and type of HM in our patients.