Hepatitis B screening rates and reactivation in solid organ malignancy patients undergoing chemotherapy in Southern Thailand

BACKGROUND/AIMS: Hepatitis B virus reactivation (HBVr) following chemotherapy (CMT) is well-known among hematologic malignancies, and screening recommendations are established. However, HBVr data in solid organ malignancy (SOM) patients are limited. This study aims to determine hepatitis B surface antigen (HBsAg) screening rates, HBV prevalence, and the rate of significant hepatitis caused by HBVr in SOM patients undergoing CMT.METHODS: Based on the Oncology unit’s registration database from 2009–2013, we retrospectively reviewed records of all SOM patients ≥18 years undergoing CMT at Songklanagarind Hospital who were followed until death or ≥6 months after CMT sessions. Exclusion criteria included patients without baseline liver function tests (LFTs) and who underwent CMT before the study period. We obtained and analyzed baseline clinical characteristics, HBsAg screening, and LFT data during follow-up.RESULTS: Of 3,231 cases in the database, 810 were eligible. The overall HBsAg screening rate in the 5-year period was 27.7%. Screening rates were low from 2009–2012 (7.8–21%) and increased in 2013 to 82.9%. The prevalence of HBV among screened patients was 7.1%. Of those, 75% underwent prophylactic antiviral therapy. During the 6-month follow-up period, there were three cases of significant hepatitis caused by HBVr (4.2% of all significant hepatitis cases); all were in the unscreened group.CONCLUSIONS: The prevalence of HBV in SOM patients undergoing CMT in our study was similar to the estimated prevalence in general Thai population, but the screening rate was quite low. Cases of HBVr causing significant hepatitis occurred in the unscreened group; therefore, HBV screening and treatment in SOM patients should be considered in HBV-endemic areas.

Hepatitis B virus reactivation induced by glucocorticoids: an important issue requiring urgent attention in dermatology / 中华皮肤科杂志

There is a high incidence of hepatitis B virus (HBV) infection in China,and dermatologists often encounter patients with skin diseases complicated by HBV infection in clinic.With the widespread use of systemic glucocorticoids in dermatology,HBV reactivation has become a constant problem to face in the treatment process.Attention should be given to risk factors of HBV reactivation,including HBV DNA replication,positive hepatitis B surface antigens (HBsAg) and positive hepatitis B core antibodies (HBcAb).According to HBV serological markers,risk stratification of HBV reactivation induced by glucocorticoids needs to be grasped,and treatment measures should be taken timely to prevent HBV reactivation.In this way,liver function impairment induced by HBV reactivation during the course of glucocorticoid therapy may be avoided to the greatest extent,which is of great benefit to clinical work.

Management and prevention of HBV reactivation in the context of immunosuppression / 临床肝胆病杂志

HBV reactivation is commonly seen during immunosuppressive therapy and is associated with high incidence and mortality rates due to hepatitis outbreak and liver decompensation, and therefore, it should be taken seriously. However, the prevention and management of this potential complication is still a difficulty in clinical practice. This article reviews the diagnostic criteria and clinical outcomes of HBV reactivation, discusses the association of immunosuppressive therapy with the risk of HBV reactivation, and outlines the strategies for the prevention of HBV reactivation and recent advances. It is pointed out that early identification of patients with HBV infection before immunosuppressive therapy is of vital importance, and the initiation of antiviral therapy at the right moment based on risk stratification can effectively reduce the risk of HBV reactivation. We hope that this review can increase the awareness of HBV reactivation among clinicians and provide an effective reference for optimizing the management and prevention of HBV infection.

Clinical issues in the diagnosis and treatment of tuberculosis patients with positive antibody to hepatitis C virus / 临床肝胆病杂志

Tuberculosis patients with positive antibody to hepatitis C virus (TB-HCV patients) are often seen in clinical practice, and these TB-HCV patients include those with HCV infection. That makes the clinical management and diagnosis/treatment of TB-HCV difficult. This article introduces the prevalence of TB-HCV around the world, and analyzes the potential issues in the diagnosis and treatment of TB-HCV patients, such as drug-drug interactions, drug-induced liver injury, HCV reactivation, and TB reactivation. Through this review, it is recommended that the management should be strengthened and the appropriate therapeutic regimen should be selected in the diagnosis and treatment of TB-HCV patients.

The induction, purification, whole genome sequencing and comparative genome analysis of a novel staphylococcus haemolyticus bacteriophage IME-SA4 / 中国医师杂志

Objective To induce a novel temperate bacteriophage from staphylococcus haemolyticus strain SA98,observe the morphology and size,complete the whole genome sequencing,analyse the structure of genome and evolutionary relationship.Methods The mitomycin C was used to induce the temperate phage from staphylococcushaemolyticus strain SA98,the induced phage was observed by transmission electron microscopy after be concentrated and purified.The genome DNA was extracted and high through sequenced.The feature of whole genome and evolutionary relationship was analyzed.Results A temperate phage IME-SA4 was successfully induced from staphylococcus haemolyticus strain SA98.Transmission electron microscopy analysis indicated that IME-SA4 had an isometric head and a non-contractile long tail.The whole genome of IME-SA4 was long as 41 843 bp,and the whole genome blast result indicated IME-SA4 shared only 13％ homology with most related strain phiRS7.Conclusions A novel staphylococcus haemolyticus temperate phage with low homology with other staphylococcusphages was successfully induced from staphylococcus haemolyticus strain SA98.The research of its morphology,whole genome sequencing and comparative genome analysis make the foundation for further study of staphylococcus phages' properties and practical application.

Correlation between TNF-α-238 gene polymorphism and hepatitis B virus reactivation in patients with malignant tumors after chemotherapy / 中华老年医学杂志

Objective To investigate the correlation between the single nucleotide polymorphism (SNP) of tumor necrosis factor (TNF-α) gene promotor-238 and hepatitis B virus (HBV) reactivation in patients with malignant tumors after chemotherapy.Methods Polymerase chain reaction-restriction fragment length polymorphism assay (PCR-RFLP) was used to detect the SNPat TNF-α-238 site among 100 malignant tumor patients with HBV infection.HBV-DNA levels in patients were detected before and after chemotherapy.HBV reactivation was defined as that HBV-DNA level greater than 10-fold increase compared with before chemotherapy or higher than 1 × 109 logcopies/ml.Results The quantification of HBV-DNA was higher after chemotherapy than before chemotherapy [(3.02±0.68) logcopies/ml vs.(2.49±0.23) logcopies/ml,t=-7.383,P=0.000].Among the patients with malignant tumor and HBV infection,the genotype frequency of G/A was higher in HBV reactivation group than in non-reactivation group after chemotherapy [27.3％ (6/22) vs.3.8％ (3/ 78),x2 =11.499,P=0.001].Conclusions HBV reactivation is associated with TNF-α-238 gene polymorphism in malignant tumor patients with HBV infection after chemotherapy.

Varicella-zoster virus infection and stroke / 国际脑血管病杂志

The varicela-zoster virus(VZV) infection causes central vasculopathy,and then leads to stroke onset. This article review s the correlation betw een VZV infection and stroke onset in order to conduct a comprehensive assessment of patients w ith VZV infection, thereby reducing the risk of stroke after VZV infection.

The progress of virus-targeted new therapy against Epstein-Barr virus-associated malignancies / 肿瘤

The Epstein-Barr virus (EBV) has been demonstrated to be associated with several human tumors, including nasopharyngeal carcinoma (NPC), Burkitt's lymphoma (BL), post-transplant lymphoproliferative disease (PTLD), Hodgkin's lymphoma (HL), non-Hodgkin's lymphomas (NHL) and gastric cancer (GC). In most EBV-associated malignancies, the tumor cells contain the viral genome. This provides a unique opportunity to develop therapeutic strategies utilizing the viral genome of EBV as a potential drug target. This review focuses on different therapeutic strategies against EBV-associated malignancies, further discusses the possible therapeutic approach using drug-induced virus activation and its certain pathways. Copyright © 2014 by TUMOR.

Progress of prevention and cure of chemoradiotherapy-related hepatitis B virus reactivation / 国际肿瘤学杂志

Reactivation of hepatitis B virus (HBV) in cancer patients with HBV infection during or after chemoradiotherapy can lead to acute liver injury,even death.Antiviral prophylaxis can reduce the occurrence of HBV reactivation and its associated morbidity.However,there is no unified standard to guide antiviral treatment.Therefore,multidisciplinary collaboration and more prospective study should be carried out to identify the individual antiviral treatment plan.

A fatal case of hepatitis B virus (HBV) reactivation during long-term, very-low-dose steroid treatment in an inactive HBV carrier

Hepatitis B virus (HBV) may be reactivated after chemotherapy or immunosuppressive therapy, and therefore administration of antiviral agents before such treatment is recommended. Most reported cases of reactivation are associated with high doses of immunosuppressive agents or combination therapy. We present a case of a previously inactive HBV carrier with an acute severe flare-up during a long-term, very-low-dose (2.5 mg/day) steroid treatment for rheumatoid arthritis. We suggest that even a minimal dose of single-regimen oral steroid can cause reactivation of indolent, inactive HBV.

A study of the latency and reactivation of HSV-1 in the rabbit cornea / 眼科

Herpes simplex keratitis models were created with healthy New Zealand rabbits. During the quiescent period, one group of the rabbits were performed autograft penetrating keratoplasty and another group cross penetrating keratoplasty with noninfeeted rabbits. After removal of the sutures, epinephrine iontophoresis was done for reactivation of the virus, and all the corneal buttons were stained positive of HSV-1 antigens. Transmission electron microscopy revealed signs of viral infection and culture of corneal graft keratoeytes also demonstrated HSV-1 infection, suggesting that the cornea was a site of HSV-1 latency and source of recurrence.