Chronic hepatitis B, non-Hodgkin's lymphoma, and effect of prophylactic antiviral therapy

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http://www.journalofclinicalvirology.com/article/PIIS1386653211001764/abstract?r\

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Chronic hepatitis B, non-Hodgkin's lymphoma, and effect of prophylactic

antiviral therapy

Yeo Myeong Kima, Sook-Hyang Jeonga, Jin-Wook Kima, Sang Hyub Leea, Jin Hyuk

Hwanga, Young Soo Parka, Nayoung Kima, Jong Seok Leea, Hyun Young Kimb, Dong Ho

Leeab

Received 19 January 2011; received in revised form 17 April 2011; accepted 3 May

2011. published online 31 May 2011.

Corrected Proof

Abstract

Background

Hepatitis B virus (HBV) infection can be associated with non-Hodgkin's lymphoma

(NHL), and prophylactic antiviral therapy is recommended for NHL patients with

chronic HBV infection who are receiving anticancer chemotherapy.

Objectives

The aims of this study were to investigate the association between HBV infection

and NHL, and to evaluate the application rate and the effect of prophylactic

antiviral therapy for HBV-infected NHL patients.

Study design

A retrospective, case–control study was performed.

Results

The prevalence of hepatitis B surface antigen in 344 patients who were

consecutively diagnosed with NHL from May 2003 to October 2009 (44 of 344;

12.8%) was significantly higher than that of 688 age- and sex-matched

health-check examinees (24 of 688; 3.5%) (adjusted odds ratio, 4.08; 95%

confidence interval, 2.44–6.85). T cell type NHL, as well as B cell type, showed

a significant association with HBV carrier rate. Among 32 NHL patients who

received anticancer chemotherapy, 30 patients (93.8%) received prophylactic

antiviral therapy, primarily lamivudine. However, HBV DNA monitoring during

antiviral therapy was frequently omitted in hemato-oncology clinics. While there

was no occurrence of hepatitis flare during antiviral therapy, withdrawal

hepatitis after discontinuation of antiviral drug occurred frequently (60%).

Conclusion

HBV may play a significant role in development of NHL, which prompts further

study on the lymphomagenic mechanism of HBV infection. Prophylactic antiviral

therapy was administered during chemotherapy to almost all of the NHL patients

with HBV infection; however, further investigation should be conducted for

determination of optimal duration and monitoring of antiviral therapy.

a Department of Internal Medicine, Seoul National University, College of

Medicine, Seoul National University Bundang Hospital, Gumi-dong 300, Bundang-gu,

Seongnam-si, Gyeonggi-do, Republic of Korea

b Health Promotion Center, Seoul National University Bundang Hospital, Gumi-dong

300, Bundang-gu, Seongnam-si, Republic of Korea

Corresponding author. Tel.: +82 31 787 7039; fax: +82 31 787 7042.

PII: S1386-6532(11)00176-4

doi:10.1016/j.jcv.2011.05.004

© 2011 Published by Elsevier Inc.

[Guest guest]

http://www.journalofclinicalvirology.com/article/PIIS1386653211001764/abstract?r\

ss=yes

Chronic hepatitis B, non-Hodgkin's lymphoma, and effect of prophylactic

antiviral therapy

Yeo Myeong Kima, Sook-Hyang Jeonga, Jin-Wook Kima, Sang Hyub Leea, Jin Hyuk

Hwanga, Young Soo Parka, Nayoung Kima, Jong Seok Leea, Hyun Young Kimb, Dong Ho

Leeab

Received 19 January 2011; received in revised form 17 April 2011; accepted 3 May

2011. published online 31 May 2011.

Corrected Proof

Abstract

Background

Hepatitis B virus (HBV) infection can be associated with non-Hodgkin's lymphoma

(NHL), and prophylactic antiviral therapy is recommended for NHL patients with

chronic HBV infection who are receiving anticancer chemotherapy.

Objectives

The aims of this study were to investigate the association between HBV infection

and NHL, and to evaluate the application rate and the effect of prophylactic

antiviral therapy for HBV-infected NHL patients.

Study design

A retrospective, case–control study was performed.

Results

The prevalence of hepatitis B surface antigen in 344 patients who were

consecutively diagnosed with NHL from May 2003 to October 2009 (44 of 344;

12.8%) was significantly higher than that of 688 age- and sex-matched

health-check examinees (24 of 688; 3.5%) (adjusted odds ratio, 4.08; 95%

confidence interval, 2.44–6.85). T cell type NHL, as well as B cell type, showed

a significant association with HBV carrier rate. Among 32 NHL patients who

received anticancer chemotherapy, 30 patients (93.8%) received prophylactic

antiviral therapy, primarily lamivudine. However, HBV DNA monitoring during

antiviral therapy was frequently omitted in hemato-oncology clinics. While there

was no occurrence of hepatitis flare during antiviral therapy, withdrawal

hepatitis after discontinuation of antiviral drug occurred frequently (60%).

Conclusion

HBV may play a significant role in development of NHL, which prompts further

study on the lymphomagenic mechanism of HBV infection. Prophylactic antiviral

therapy was administered during chemotherapy to almost all of the NHL patients

with HBV infection; however, further investigation should be conducted for

determination of optimal duration and monitoring of antiviral therapy.

a Department of Internal Medicine, Seoul National University, College of

Medicine, Seoul National University Bundang Hospital, Gumi-dong 300, Bundang-gu,

Seongnam-si, Gyeonggi-do, Republic of Korea

b Health Promotion Center, Seoul National University Bundang Hospital, Gumi-dong

300, Bundang-gu, Seongnam-si, Republic of Korea

Corresponding author. Tel.: +82 31 787 7039; fax: +82 31 787 7042.

PII: S1386-6532(11)00176-4

doi:10.1016/j.jcv.2011.05.004

© 2011 Published by Elsevier Inc.