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Ann. hepatol ; 16(2): 198-206, Mar.-Apr. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-887223

RESUMO

ABSTRACT HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Ativação Viral , Linfoma não Hodgkin/tratamento farmacológico , Doença de Hodgkin/tratamento farmacológico , Vírus da Hepatite B/patogenicidade , Hospedeiro Imunocomprometido , Hepatite C/virologia , Hepacivirus/patogenicidade , Anticorpos Anti-Hepatite C/sangue , Rituximab/efeitos adversos , Hepatite B/virologia , Antineoplásicos/efeitos adversos , Antivirais/administração & dosagem , Linfoma não Hodgkin/imunologia , Doença de Hodgkin/imunologia , Biomarcadores/sangue , Vírus da Hepatite B/imunologia , Estudos Retrospectivos , Hepatite C/diagnóstico , Hepatite C/imunologia , Hepatite C/prevenção & controle , Hepacivirus/imunologia , Centros de Atenção Terciária , Hepatite B/diagnóstico , Hepatite B/imunologia , Hepatite B/prevenção & controle , Itália
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