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Article: Hepatitis B reactivation after withdrawal of pre-emptive lamivudine in patients with haematological malignancy on completion of cytotoxic chemotherapy

TitleHepatitis B reactivation after withdrawal of pre-emptive lamivudine in patients with haematological malignancy on completion of cytotoxic chemotherapy
Authors
Issue Date2005
PublisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
Citation
Gut, 2005, v. 54 n. 11, p. 1597-1603 How to Cite?
AbstractBackground: The hepatic outcome of hepatitis B surface antigen (HBsAg) positive patients undergoing chemotherapy after withdrawal of pre-emptive lamivudine is unknown. Aims: To examine the occurrence of hepatitis B virus (HBV) reactivation after withdrawal of pre-emptive lamivudine. Methods: Pre-emptive lamivudine was started one week before initiation of chemotherapy in 46 consecutive HBsAg positive patients and continued for the entire duration of chemotherapy. Pre-emptive lamivudine was stopped at a median 3.1 (range 3.0-3.4) months after completion of chemotherapy. Patients were longitudinally followed up after withdrawal of pre-emptive lamivudine. Results: Median time of follow up after withdrawal of lamivudine was 25.7 (range 5.7-75.7) months. Eleven of the 46 patients (23.9%) developed HBV reactivation after withdrawal of pre-emptive lamivudine. Eight of the 16 patients with high pre-chemotherapy HBV DNA (≥10 4 copies/ml) compared with three of the 30 patients with low pre-chemotherapy HBV DNA (<10 4 copies/ml) developed HBV reactivation (50.0% v 10.0%, respectively; p<0.001). Hepatitis B e antigen positive patients were also more likely to develop HBV reactivation (5/11 (45.5%) v 6/35 (17.1%), respectively; p = 0.041). A high pre-chemotherapy HBV DNA (≥10 4 copies/ml) was the most important risk factor for HBV reactivation after withdrawal of pre-emptive lamivudine on Cox proportional hazards analysis (relative risk 16.13, (95% confidence interval 2.99-87.01; p = 0.001). Conclusions: HBV reactivation is more likely to occur in patients with high pre-chemotherapy HBV DNA after withdrawal of pre-emptive lamivudine. A more prolonged course of antiviral therapy may be necessary in these patients after completion of chemotherapy in order to reduce post-chemotherapy HBV reactivation.
Persistent Identifierhttp://hdl.handle.net/10722/44966
ISSN
2015 Impact Factor: 14.921
2015 SCImago Journal Rankings: 6.474
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHui, CKen_HK
dc.contributor.authorCheung, WWWen_HK
dc.contributor.authorAu, WYen_HK
dc.contributor.authorLie, AKWen_HK
dc.contributor.authorZhang, HYen_HK
dc.contributor.authorYueng, YHen_HK
dc.contributor.authorWong, BCYen_HK
dc.contributor.authorLeung, Nen_HK
dc.contributor.authorKwong, YLen_HK
dc.contributor.authorLiang, Ren_HK
dc.contributor.authorLau, GKKen_HK
dc.date.accessioned2007-10-30T06:14:36Z-
dc.date.available2007-10-30T06:14:36Z-
dc.date.issued2005en_HK
dc.identifier.citationGut, 2005, v. 54 n. 11, p. 1597-1603en_HK
dc.identifier.issn0017-5749en_HK
dc.identifier.urihttp://hdl.handle.net/10722/44966-
dc.description.abstractBackground: The hepatic outcome of hepatitis B surface antigen (HBsAg) positive patients undergoing chemotherapy after withdrawal of pre-emptive lamivudine is unknown. Aims: To examine the occurrence of hepatitis B virus (HBV) reactivation after withdrawal of pre-emptive lamivudine. Methods: Pre-emptive lamivudine was started one week before initiation of chemotherapy in 46 consecutive HBsAg positive patients and continued for the entire duration of chemotherapy. Pre-emptive lamivudine was stopped at a median 3.1 (range 3.0-3.4) months after completion of chemotherapy. Patients were longitudinally followed up after withdrawal of pre-emptive lamivudine. Results: Median time of follow up after withdrawal of lamivudine was 25.7 (range 5.7-75.7) months. Eleven of the 46 patients (23.9%) developed HBV reactivation after withdrawal of pre-emptive lamivudine. Eight of the 16 patients with high pre-chemotherapy HBV DNA (≥10 4 copies/ml) compared with three of the 30 patients with low pre-chemotherapy HBV DNA (<10 4 copies/ml) developed HBV reactivation (50.0% v 10.0%, respectively; p<0.001). Hepatitis B e antigen positive patients were also more likely to develop HBV reactivation (5/11 (45.5%) v 6/35 (17.1%), respectively; p = 0.041). A high pre-chemotherapy HBV DNA (≥10 4 copies/ml) was the most important risk factor for HBV reactivation after withdrawal of pre-emptive lamivudine on Cox proportional hazards analysis (relative risk 16.13, (95% confidence interval 2.99-87.01; p = 0.001). Conclusions: HBV reactivation is more likely to occur in patients with high pre-chemotherapy HBV DNA after withdrawal of pre-emptive lamivudine. A more prolonged course of antiviral therapy may be necessary in these patients after completion of chemotherapy in order to reduce post-chemotherapy HBV reactivation.en_HK
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dc.format.mimetypeapplication/pdf-
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dc.format.mimetypetext/plain-
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dc.languageengen_HK
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/en_HK
dc.relation.ispartofGuten_HK
dc.rightsGut. Copyright © B M J Publishing Group.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshHematologic-Neoplasms-drug-therapyen_HK
dc.subject.meshHepatitis-B-prevention-and-controlen_HK
dc.subject.meshHepatitis-B-virus-physiologyen_HK
dc.subject.meshLamivudine-therapeutic-useen_HK
dc.subject.meshVirus-Activation-drug-effectsen_HK
dc.titleHepatitis B reactivation after withdrawal of pre-emptive lamivudine in patients with haematological malignancy on completion of cytotoxic chemotherapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0017-5749&volume=54&issue=11&spage=1597&epage=1603&date=2005&atitle=Hepatitis+B+reactivation+after+withdrawal+of+pre-emptive+lamivudine+in+patients+with+haematological+malignancy+on+completion+of+cytotoxic+chemotherapyen_HK
dc.identifier.emailWong, BCY:bcywong@hku.hken_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.emailLiang, R:rliang@hku.hken_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.identifier.authorityLiang, R=rp00345en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1136/gut.2005.070763en_HK
dc.identifier.pmid16000641-
dc.identifier.pmcidPMC1774754-
dc.identifier.scopuseid_2-s2.0-27444438889en_HK
dc.identifier.hkuros121274-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27444438889&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume54en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1597en_HK
dc.identifier.epage1603en_HK
dc.identifier.isiWOS:000232581800021-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridHui, CK=35082057900en_HK
dc.identifier.scopusauthoridCheung, WWW=8615134400en_HK
dc.identifier.scopusauthoridAu, WY=7202383089en_HK
dc.identifier.scopusauthoridLie, AKW=7004510870en_HK
dc.identifier.scopusauthoridZhang, HY=8965962000en_HK
dc.identifier.scopusauthoridYueng, YH=8965962100en_HK
dc.identifier.scopusauthoridWong, BCY=7402023340en_HK
dc.identifier.scopusauthoridLeung, N=26643107200en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK
dc.identifier.scopusauthoridLiang, R=26643224900en_HK
dc.identifier.scopusauthoridLau, GKK=7102301257en_HK

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