[Immunosuppressive therapy or chemotherapy-induced reactivation of hepatitis B virus infection]

Immunosuppressive treatments, such as rituximab-containing chemotherapy or stem cell transplantation, have been widely performed following recent developments in cancer therapy. Immunosuppressive therapy or chemotherapy(IS/CT)-induced reactivation of the hepatitis B virus(HBV)in HBsAg-positive HBV-carriers is a well-known phenomenon. It has recently been demonstrated that HBV-reactivation also occurs in HBV-resolved patients who are negative for HBsAg, and positive for HBsAb and/or HBcAb. This is because de novo hepatitis B, which occurs in HBV-resolved patients with a recurrence of HBV hepatitis, have a high risk of fulminant hepatitis with an extremely poor prognosis. In this regard, prevention a guideline for IS/ CT-induced HBV-reactivation was established in Japan. However, the incidence of, and risk factors for, IS/CT-induced HBV- reactivation in HBV-resolved patients in Japan has not yet been elucidated. We retrospectively analyzed IS/CT-induced HBV- reactivation in resolved HBV-patients with hematological disorders in our hospital. Reactivation occurred in 5. 0%patients(5/ 101), and administration of more than 2 regimens for the hematological disorder was identified as an independent risk factor for HBV-reactivation in multivariate analysis. Further investigation of the risk factors for HBV-reactivation and the efficacy of the guideline should be performed during multicenter prospective study.