Safeguards needed against hepatitis B reactivation

[Guest guest]

http://www.yomiuri.co.jp/dy/national/T110919004477.htm

(see illustrations on web page)

Safeguards needed against hepatitis B reactivation

Makiko Tatebayashi and Yoshiaki Takeuchi / Yomiuri Shimbun Staff Writers

New screening systems are needed to prevent patients with a history of hepatitis

B infection from suffering a sudden reactivation of the virus due to taking

drugs used to treat other diseases, such as blood cancer and rheumatism,

according to some health experts.

The link between the drugs and hepatitis B reactivation was raised in recent

health ministry research.

Early detection of hepatitis B recurrence can protect patients from developing

fulminant hepatitis--a sudden and highly acute condition that can be fatal.

However, such screening requires tests to check whether the virus genes are

active, and the tests are not covered by health insurance.

Doctors and others are calling for the tests to be covered by health insurance,

and for the introduction of other measures to aid early detection of the virus.

Three years ago, Yukitomo Urata, a doctor at Seihoku Chuo Hospital in

Goshogawara, Aomori Prefecture, was worried and puzzled by the condition of a

patient suffering from rheumatism.

" Why hasn't the patient's condition improved? " Urata wondered.

The patient had developed liver problems while being treated for rheumatism.

Urata tried prescribing various drugs to treat the liver problems, but none

worked.

Urata then heard from his friend, an internal medicine doctor and liver

specialist, that people who had previously had hepatitis B infections could

suffer a reactivation of the virus.

Urata prescribed hepatitis B antiviral drugs, and the patient's condition

improved.

Prompted by this case, Urata examined the records of 516 people who were

receiving treatment for rheumatism at the hospital. He found that 157, or about

30 percent, had previously been infected with the hepatitis B virus. Thirteen of

those patients, or 8 percent, had suffered reactivation of the virus while

receiving treatment for rheumatism.

Antiviral drugs were given to the patients whose hepatitis B infection had

advanced beyond a certain degree of seriousness, and as a result none of them

developed inflammation of the liver.

In many cases, a person infected with hepatitis B recovers from the infection

without needing treatment. However, the virus genes remain in the person's liver

even after recovery.

Relatively new, highly immunosuppressive drugs--and treatment methods that

involve the use of immunosuppressive drugs--are suspected of having triggered a

reactivation of the hepatitis B virus in a number of cases.

In the 2000s, hepatitis B reactivation was reported in patients who were taking

a drug used to treat malignant lymphoma. The virus reactivation was thought to

be a side effect of the lymphoma drug.

Urata's survey and other studies suggest drugs used to treat other conditions

can also trigger a reactivation of hepatitis B.

Since 2003, drugs that suppress certain functions of the immune system have been

used widely to treat rheumatism. A treatment method that involves the use of

more conventional immunosuppressive drugs has also become common.

Such treatments have proved effective in easing symptoms of rheumatism, but

their immunosuppressive functions are believed to increase patients'

susceptibility to hepatitis B reactivation.

===

Early detection is treatment key

Patients treated with antiviral drugs in the early stages of hepatitis B

reactivation have not suffered severe symptoms, but some patients who have not

received antiviral treatment have died as result of developing fulminant

hepatitis.

A nationwide survey conducted by the health ministry's research team on

fulminant hepatitis found at least 17 patients who had recovered from hepatitis

B later died of fulminant hepatitis after undergoing treatment for other

diseases from 2004 to 2009.

Of those, 13 patients underwent treatment for malignant lymphoma, while two

others received treatment for leukemia and one each were treated for multiple

myeloma and breast cancer.

It has also been reported that another patient who had been infected with the

virus developed fulminant hepatitis and died after being treated for rheumatism.

One other patient had a hepatitis B recurrence after being treated for

interstitial pneumonia.

All 13 patients who died after being treated for malignant lymphoma had been

administered the new highly immunosuppressive drug Rituxan. It is not yet known

what other drugs may have caused reactivation of the virus.

The Health, Labor and Welfare Ministry's research team, led by Prof. Satoshi

Mochida of Saitama Medical University, has been conducting research on which

drugs and treatments could cause the hepatitis B virus to reactivate.

" Immunosuppressive drugs are used for the treatment of various diseases. We need

to identify diseases [whose drug treatments could cause the virus reactivation]

and determine the best time to start treatment for [reactivated] viruses. But

more importantly, all diagnosis and treatment departments need to take

precautions on the matter, " said Mochida.

It is necessary to conduct a viral gene test to detect the reactivation of the

virus in its early stages. But these tests are not covered by health insurance.

Therefore, only some institutions have taken steps to conduct the tests.

A Tokyo-based medical practitioner treating many rheumatism patients said: " I've

asked the nearest university hospital to conduct viral gene tests. The test

should be covered by insurance so that hospitals nationwide can conduct the

test. "

A health ministry official said, " We'll consider what measures should be taken

after sorting out problems associated with this issue. "

(Sep. 20, 2011)

[Guest guest]

http://www.yomiuri.co.jp/dy/national/T110919004477.htm

(see illustrations on web page)

Safeguards needed against hepatitis B reactivation

Makiko Tatebayashi and Yoshiaki Takeuchi / Yomiuri Shimbun Staff Writers

New screening systems are needed to prevent patients with a history of hepatitis

B infection from suffering a sudden reactivation of the virus due to taking

drugs used to treat other diseases, such as blood cancer and rheumatism,

according to some health experts.

The link between the drugs and hepatitis B reactivation was raised in recent

health ministry research.

Early detection of hepatitis B recurrence can protect patients from developing

fulminant hepatitis--a sudden and highly acute condition that can be fatal.

However, such screening requires tests to check whether the virus genes are

active, and the tests are not covered by health insurance.

Doctors and others are calling for the tests to be covered by health insurance,

and for the introduction of other measures to aid early detection of the virus.

Three years ago, Yukitomo Urata, a doctor at Seihoku Chuo Hospital in

Goshogawara, Aomori Prefecture, was worried and puzzled by the condition of a

patient suffering from rheumatism.

" Why hasn't the patient's condition improved? " Urata wondered.

The patient had developed liver problems while being treated for rheumatism.

Urata tried prescribing various drugs to treat the liver problems, but none

worked.

Urata then heard from his friend, an internal medicine doctor and liver

specialist, that people who had previously had hepatitis B infections could

suffer a reactivation of the virus.

Urata prescribed hepatitis B antiviral drugs, and the patient's condition

improved.

Prompted by this case, Urata examined the records of 516 people who were

receiving treatment for rheumatism at the hospital. He found that 157, or about

30 percent, had previously been infected with the hepatitis B virus. Thirteen of

those patients, or 8 percent, had suffered reactivation of the virus while

receiving treatment for rheumatism.

Antiviral drugs were given to the patients whose hepatitis B infection had

advanced beyond a certain degree of seriousness, and as a result none of them

developed inflammation of the liver.

In many cases, a person infected with hepatitis B recovers from the infection

without needing treatment. However, the virus genes remain in the person's liver

even after recovery.

Relatively new, highly immunosuppressive drugs--and treatment methods that

involve the use of immunosuppressive drugs--are suspected of having triggered a

reactivation of the hepatitis B virus in a number of cases.

In the 2000s, hepatitis B reactivation was reported in patients who were taking

a drug used to treat malignant lymphoma. The virus reactivation was thought to

be a side effect of the lymphoma drug.

Urata's survey and other studies suggest drugs used to treat other conditions

can also trigger a reactivation of hepatitis B.

Since 2003, drugs that suppress certain functions of the immune system have been

used widely to treat rheumatism. A treatment method that involves the use of

more conventional immunosuppressive drugs has also become common.

Such treatments have proved effective in easing symptoms of rheumatism, but

their immunosuppressive functions are believed to increase patients'

susceptibility to hepatitis B reactivation.

===

Early detection is treatment key

Patients treated with antiviral drugs in the early stages of hepatitis B

reactivation have not suffered severe symptoms, but some patients who have not

received antiviral treatment have died as result of developing fulminant

hepatitis.

A nationwide survey conducted by the health ministry's research team on

fulminant hepatitis found at least 17 patients who had recovered from hepatitis

B later died of fulminant hepatitis after undergoing treatment for other

diseases from 2004 to 2009.

Of those, 13 patients underwent treatment for malignant lymphoma, while two

others received treatment for leukemia and one each were treated for multiple

myeloma and breast cancer.

It has also been reported that another patient who had been infected with the

virus developed fulminant hepatitis and died after being treated for rheumatism.

One other patient had a hepatitis B recurrence after being treated for

interstitial pneumonia.

All 13 patients who died after being treated for malignant lymphoma had been

administered the new highly immunosuppressive drug Rituxan. It is not yet known

what other drugs may have caused reactivation of the virus.

The Health, Labor and Welfare Ministry's research team, led by Prof. Satoshi

Mochida of Saitama Medical University, has been conducting research on which

drugs and treatments could cause the hepatitis B virus to reactivate.

" Immunosuppressive drugs are used for the treatment of various diseases. We need

to identify diseases [whose drug treatments could cause the virus reactivation]

and determine the best time to start treatment for [reactivated] viruses. But

more importantly, all diagnosis and treatment departments need to take

precautions on the matter, " said Mochida.

It is necessary to conduct a viral gene test to detect the reactivation of the

virus in its early stages. But these tests are not covered by health insurance.

Therefore, only some institutions have taken steps to conduct the tests.

A Tokyo-based medical practitioner treating many rheumatism patients said: " I've

asked the nearest university hospital to conduct viral gene tests. The test

should be covered by insurance so that hospitals nationwide can conduct the

test. "

A health ministry official said, " We'll consider what measures should be taken

after sorting out problems associated with this issue. "

(Sep. 20, 2011)

[Guest guest]

http://www.yomiuri.co.jp/dy/national/T110919004477.htm

(see illustrations on web page)

Safeguards needed against hepatitis B reactivation

Makiko Tatebayashi and Yoshiaki Takeuchi / Yomiuri Shimbun Staff Writers

New screening systems are needed to prevent patients with a history of hepatitis

B infection from suffering a sudden reactivation of the virus due to taking

drugs used to treat other diseases, such as blood cancer and rheumatism,

according to some health experts.

The link between the drugs and hepatitis B reactivation was raised in recent

health ministry research.

Early detection of hepatitis B recurrence can protect patients from developing

fulminant hepatitis--a sudden and highly acute condition that can be fatal.

However, such screening requires tests to check whether the virus genes are

active, and the tests are not covered by health insurance.

Doctors and others are calling for the tests to be covered by health insurance,

and for the introduction of other measures to aid early detection of the virus.

Three years ago, Yukitomo Urata, a doctor at Seihoku Chuo Hospital in

Goshogawara, Aomori Prefecture, was worried and puzzled by the condition of a

patient suffering from rheumatism.

" Why hasn't the patient's condition improved? " Urata wondered.

The patient had developed liver problems while being treated for rheumatism.

Urata tried prescribing various drugs to treat the liver problems, but none

worked.

Urata then heard from his friend, an internal medicine doctor and liver

specialist, that people who had previously had hepatitis B infections could

suffer a reactivation of the virus.

Urata prescribed hepatitis B antiviral drugs, and the patient's condition

improved.

Prompted by this case, Urata examined the records of 516 people who were

receiving treatment for rheumatism at the hospital. He found that 157, or about

30 percent, had previously been infected with the hepatitis B virus. Thirteen of

those patients, or 8 percent, had suffered reactivation of the virus while

receiving treatment for rheumatism.

Antiviral drugs were given to the patients whose hepatitis B infection had

advanced beyond a certain degree of seriousness, and as a result none of them

developed inflammation of the liver.

In many cases, a person infected with hepatitis B recovers from the infection

without needing treatment. However, the virus genes remain in the person's liver

even after recovery.

Relatively new, highly immunosuppressive drugs--and treatment methods that

involve the use of immunosuppressive drugs--are suspected of having triggered a

reactivation of the hepatitis B virus in a number of cases.

In the 2000s, hepatitis B reactivation was reported in patients who were taking

a drug used to treat malignant lymphoma. The virus reactivation was thought to

be a side effect of the lymphoma drug.

Urata's survey and other studies suggest drugs used to treat other conditions

can also trigger a reactivation of hepatitis B.

Since 2003, drugs that suppress certain functions of the immune system have been

used widely to treat rheumatism. A treatment method that involves the use of

more conventional immunosuppressive drugs has also become common.

Such treatments have proved effective in easing symptoms of rheumatism, but

their immunosuppressive functions are believed to increase patients'

susceptibility to hepatitis B reactivation.

===

Early detection is treatment key

Patients treated with antiviral drugs in the early stages of hepatitis B

reactivation have not suffered severe symptoms, but some patients who have not

received antiviral treatment have died as result of developing fulminant

hepatitis.

A nationwide survey conducted by the health ministry's research team on

fulminant hepatitis found at least 17 patients who had recovered from hepatitis

B later died of fulminant hepatitis after undergoing treatment for other

diseases from 2004 to 2009.

Of those, 13 patients underwent treatment for malignant lymphoma, while two

others received treatment for leukemia and one each were treated for multiple

myeloma and breast cancer.

It has also been reported that another patient who had been infected with the

virus developed fulminant hepatitis and died after being treated for rheumatism.

One other patient had a hepatitis B recurrence after being treated for

interstitial pneumonia.

All 13 patients who died after being treated for malignant lymphoma had been

administered the new highly immunosuppressive drug Rituxan. It is not yet known

what other drugs may have caused reactivation of the virus.

The Health, Labor and Welfare Ministry's research team, led by Prof. Satoshi

Mochida of Saitama Medical University, has been conducting research on which

drugs and treatments could cause the hepatitis B virus to reactivate.

" Immunosuppressive drugs are used for the treatment of various diseases. We need

to identify diseases [whose drug treatments could cause the virus reactivation]

and determine the best time to start treatment for [reactivated] viruses. But

more importantly, all diagnosis and treatment departments need to take

precautions on the matter, " said Mochida.

It is necessary to conduct a viral gene test to detect the reactivation of the

virus in its early stages. But these tests are not covered by health insurance.

Therefore, only some institutions have taken steps to conduct the tests.

A Tokyo-based medical practitioner treating many rheumatism patients said: " I've

asked the nearest university hospital to conduct viral gene tests. The test

should be covered by insurance so that hospitals nationwide can conduct the

test. "

A health ministry official said, " We'll consider what measures should be taken

after sorting out problems associated with this issue. "

(Sep. 20, 2011)

[Guest guest]

http://www.yomiuri.co.jp/dy/national/T110919004477.htm

(see illustrations on web page)

Safeguards needed against hepatitis B reactivation

Makiko Tatebayashi and Yoshiaki Takeuchi / Yomiuri Shimbun Staff Writers

New screening systems are needed to prevent patients with a history of hepatitis

B infection from suffering a sudden reactivation of the virus due to taking

drugs used to treat other diseases, such as blood cancer and rheumatism,

according to some health experts.

The link between the drugs and hepatitis B reactivation was raised in recent

health ministry research.

Early detection of hepatitis B recurrence can protect patients from developing

fulminant hepatitis--a sudden and highly acute condition that can be fatal.

However, such screening requires tests to check whether the virus genes are

active, and the tests are not covered by health insurance.

Doctors and others are calling for the tests to be covered by health insurance,

and for the introduction of other measures to aid early detection of the virus.

Three years ago, Yukitomo Urata, a doctor at Seihoku Chuo Hospital in

Goshogawara, Aomori Prefecture, was worried and puzzled by the condition of a

patient suffering from rheumatism.

" Why hasn't the patient's condition improved? " Urata wondered.

The patient had developed liver problems while being treated for rheumatism.

Urata tried prescribing various drugs to treat the liver problems, but none

worked.

Urata then heard from his friend, an internal medicine doctor and liver

specialist, that people who had previously had hepatitis B infections could

suffer a reactivation of the virus.

Urata prescribed hepatitis B antiviral drugs, and the patient's condition

improved.

Prompted by this case, Urata examined the records of 516 people who were

receiving treatment for rheumatism at the hospital. He found that 157, or about

30 percent, had previously been infected with the hepatitis B virus. Thirteen of

those patients, or 8 percent, had suffered reactivation of the virus while

receiving treatment for rheumatism.

Antiviral drugs were given to the patients whose hepatitis B infection had

advanced beyond a certain degree of seriousness, and as a result none of them

developed inflammation of the liver.

In many cases, a person infected with hepatitis B recovers from the infection

without needing treatment. However, the virus genes remain in the person's liver

even after recovery.

Relatively new, highly immunosuppressive drugs--and treatment methods that

involve the use of immunosuppressive drugs--are suspected of having triggered a

reactivation of the hepatitis B virus in a number of cases.

In the 2000s, hepatitis B reactivation was reported in patients who were taking

a drug used to treat malignant lymphoma. The virus reactivation was thought to

be a side effect of the lymphoma drug.

Urata's survey and other studies suggest drugs used to treat other conditions

can also trigger a reactivation of hepatitis B.

Since 2003, drugs that suppress certain functions of the immune system have been

used widely to treat rheumatism. A treatment method that involves the use of

more conventional immunosuppressive drugs has also become common.

Such treatments have proved effective in easing symptoms of rheumatism, but

their immunosuppressive functions are believed to increase patients'

susceptibility to hepatitis B reactivation.

===

Early detection is treatment key

Patients treated with antiviral drugs in the early stages of hepatitis B

reactivation have not suffered severe symptoms, but some patients who have not

received antiviral treatment have died as result of developing fulminant

hepatitis.

A nationwide survey conducted by the health ministry's research team on

fulminant hepatitis found at least 17 patients who had recovered from hepatitis

B later died of fulminant hepatitis after undergoing treatment for other

diseases from 2004 to 2009.

Of those, 13 patients underwent treatment for malignant lymphoma, while two

others received treatment for leukemia and one each were treated for multiple

myeloma and breast cancer.

It has also been reported that another patient who had been infected with the

virus developed fulminant hepatitis and died after being treated for rheumatism.

One other patient had a hepatitis B recurrence after being treated for

interstitial pneumonia.

All 13 patients who died after being treated for malignant lymphoma had been

administered the new highly immunosuppressive drug Rituxan. It is not yet known

what other drugs may have caused reactivation of the virus.

The Health, Labor and Welfare Ministry's research team, led by Prof. Satoshi

Mochida of Saitama Medical University, has been conducting research on which

drugs and treatments could cause the hepatitis B virus to reactivate.

" Immunosuppressive drugs are used for the treatment of various diseases. We need

to identify diseases [whose drug treatments could cause the virus reactivation]

and determine the best time to start treatment for [reactivated] viruses. But

more importantly, all diagnosis and treatment departments need to take

precautions on the matter, " said Mochida.

It is necessary to conduct a viral gene test to detect the reactivation of the

virus in its early stages. But these tests are not covered by health insurance.

Therefore, only some institutions have taken steps to conduct the tests.

A Tokyo-based medical practitioner treating many rheumatism patients said: " I've

asked the nearest university hospital to conduct viral gene tests. The test

should be covered by insurance so that hospitals nationwide can conduct the

test. "

A health ministry official said, " We'll consider what measures should be taken

after sorting out problems associated with this issue. "

(Sep. 20, 2011)