Hepatitis B virus reactivation in breast cancer patients undergoing cytotoxic chemotherapy and the role of preemptive lamivudine administration

[Guest guest]

Liver International

Volume 24 Issue 6 Page 540 - December 2004

doi:10.1111/j.1478-3231.2004.0964.x

Clinical Studies

Hepatitis B virus reactivation in breast cancer patients undergoing

cytotoxic chemotherapy and the role of preemptive lamivudine administration

M. S. Dai1, P. F. Wu1, R. Y. Shyu2, J. J. Lu2 and T. Y. Chao1

Abstract: Background: Recent data suggest that hepatitis B virus (HBV)

reactivation develops in 41% of breast cancer (BC) patients carrying HBV

after chemotherapy. Our study aimed to determine the role of preemptive use

of lamivudine in BC patients undergoing chemotherapy.

Patients and methods: The test group consisted of 11 female patients with BC

who were seropositive for hepatitis B surface antigen (HBsAg). Of these, 10

patients were treated in an adjuvant setting and one for metastatic disease.

Lamivudine was given from the start of chemotherapy and was maintained until

1 month after the last infusion of chemotherapy. The control group consisted

of nine historical BC patients carrying HBV and received similar systemic

chemotherapy without preemptive lamivudine. Variables including HBsAg, HBV

envelope antigen, anti-HBV envelope antibody, serial serum alanine

transaminase (ALT), quantitative HBV viral DNA analysis, and HBV-DNA precore

promoter and precore sequence were monitored. Test for emergence of mutant

strains, notably nucleotide 550, was performed 6 months after the completion

of chemotherapy.

Results: All patients tolerated lamivudine well without development of

evident HBV reactivation or overt hepatitis. Serum ALT remained unchanged

without rebound hepatitis after cessation of chemotherapy and withdrawal of

lamivudine. No emergence of lamivudine-selective resistant strain (so-called

tyrosinemethionineaspartateaspartate mutations) was observed.

Conclusions: Our results encourage preemptive use of lamivudine for

prevention of HBV reactivation in patients who need short-term chemotherapy.

[Guest guest]

Liver International

Volume 24 Issue 6 Page 540 - December 2004

doi:10.1111/j.1478-3231.2004.0964.x

Clinical Studies

Hepatitis B virus reactivation in breast cancer patients undergoing

cytotoxic chemotherapy and the role of preemptive lamivudine administration

M. S. Dai1, P. F. Wu1, R. Y. Shyu2, J. J. Lu2 and T. Y. Chao1

Abstract: Background: Recent data suggest that hepatitis B virus (HBV)

reactivation develops in 41% of breast cancer (BC) patients carrying HBV

after chemotherapy. Our study aimed to determine the role of preemptive use

of lamivudine in BC patients undergoing chemotherapy.

Patients and methods: The test group consisted of 11 female patients with BC

who were seropositive for hepatitis B surface antigen (HBsAg). Of these, 10

patients were treated in an adjuvant setting and one for metastatic disease.

Lamivudine was given from the start of chemotherapy and was maintained until

1 month after the last infusion of chemotherapy. The control group consisted

of nine historical BC patients carrying HBV and received similar systemic

chemotherapy without preemptive lamivudine. Variables including HBsAg, HBV

envelope antigen, anti-HBV envelope antibody, serial serum alanine

transaminase (ALT), quantitative HBV viral DNA analysis, and HBV-DNA precore

promoter and precore sequence were monitored. Test for emergence of mutant

strains, notably nucleotide 550, was performed 6 months after the completion

of chemotherapy.

Results: All patients tolerated lamivudine well without development of

evident HBV reactivation or overt hepatitis. Serum ALT remained unchanged

without rebound hepatitis after cessation of chemotherapy and withdrawal of

lamivudine. No emergence of lamivudine-selective resistant strain (so-called

tyrosinemethionineaspartateaspartate mutations) was observed.

Conclusions: Our results encourage preemptive use of lamivudine for

prevention of HBV reactivation in patients who need short-term chemotherapy.

[Guest guest]

Liver International

Volume 24 Issue 6 Page 540 - December 2004

doi:10.1111/j.1478-3231.2004.0964.x

Clinical Studies

Hepatitis B virus reactivation in breast cancer patients undergoing

cytotoxic chemotherapy and the role of preemptive lamivudine administration

M. S. Dai1, P. F. Wu1, R. Y. Shyu2, J. J. Lu2 and T. Y. Chao1

Abstract: Background: Recent data suggest that hepatitis B virus (HBV)

reactivation develops in 41% of breast cancer (BC) patients carrying HBV

after chemotherapy. Our study aimed to determine the role of preemptive use

of lamivudine in BC patients undergoing chemotherapy.

Patients and methods: The test group consisted of 11 female patients with BC

who were seropositive for hepatitis B surface antigen (HBsAg). Of these, 10

patients were treated in an adjuvant setting and one for metastatic disease.

Lamivudine was given from the start of chemotherapy and was maintained until

1 month after the last infusion of chemotherapy. The control group consisted

of nine historical BC patients carrying HBV and received similar systemic

chemotherapy without preemptive lamivudine. Variables including HBsAg, HBV

envelope antigen, anti-HBV envelope antibody, serial serum alanine

transaminase (ALT), quantitative HBV viral DNA analysis, and HBV-DNA precore

promoter and precore sequence were monitored. Test for emergence of mutant

strains, notably nucleotide 550, was performed 6 months after the completion

of chemotherapy.

Results: All patients tolerated lamivudine well without development of

evident HBV reactivation or overt hepatitis. Serum ALT remained unchanged

without rebound hepatitis after cessation of chemotherapy and withdrawal of

lamivudine. No emergence of lamivudine-selective resistant strain (so-called

tyrosinemethionineaspartateaspartate mutations) was observed.

Conclusions: Our results encourage preemptive use of lamivudine for

prevention of HBV reactivation in patients who need short-term chemotherapy.

[Guest guest]

Liver International

Volume 24 Issue 6 Page 540 - December 2004

doi:10.1111/j.1478-3231.2004.0964.x

Clinical Studies

Hepatitis B virus reactivation in breast cancer patients undergoing

cytotoxic chemotherapy and the role of preemptive lamivudine administration

M. S. Dai1, P. F. Wu1, R. Y. Shyu2, J. J. Lu2 and T. Y. Chao1

Abstract: Background: Recent data suggest that hepatitis B virus (HBV)

reactivation develops in 41% of breast cancer (BC) patients carrying HBV

after chemotherapy. Our study aimed to determine the role of preemptive use

of lamivudine in BC patients undergoing chemotherapy.

Patients and methods: The test group consisted of 11 female patients with BC

who were seropositive for hepatitis B surface antigen (HBsAg). Of these, 10

patients were treated in an adjuvant setting and one for metastatic disease.

Lamivudine was given from the start of chemotherapy and was maintained until

1 month after the last infusion of chemotherapy. The control group consisted

of nine historical BC patients carrying HBV and received similar systemic

chemotherapy without preemptive lamivudine. Variables including HBsAg, HBV

envelope antigen, anti-HBV envelope antibody, serial serum alanine

transaminase (ALT), quantitative HBV viral DNA analysis, and HBV-DNA precore

promoter and precore sequence were monitored. Test for emergence of mutant

strains, notably nucleotide 550, was performed 6 months after the completion

of chemotherapy.

Results: All patients tolerated lamivudine well without development of

evident HBV reactivation or overt hepatitis. Serum ALT remained unchanged

without rebound hepatitis after cessation of chemotherapy and withdrawal of

lamivudine. No emergence of lamivudine-selective resistant strain (so-called

tyrosinemethionineaspartateaspartate mutations) was observed.

Conclusions: Our results encourage preemptive use of lamivudine for

prevention of HBV reactivation in patients who need short-term chemotherapy.