Reactivation of overt and occult hepatitis B infection in various immunosuppressive settings

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J Med Virol. 2011 Nov;83(11):1909-16. doi: 10.1002/jmv.22199. Epub 2011 Aug 23.

Reactivation of overt and occult hepatitis B infection in various

immunosuppressive settings.

Coppola N, Tonziello G, Pisaturo M, Messina V, Guastafierro S, Fiore M, Iodice

V, Sagnelli C, Stanzione M, Capoluongo N, Pasquale G, Sagnelli E.

Source

Department of Public Medicine, Section of Infectious Diseases, Second University

of Naples, Naples, Italy.

Abstract

The aim of the study was to evaluate clinical and virological differences in HBV

reactivation between patients with overt and occult HBV infection. Twenty-three

consecutive patients with symptomatic HBV reactivation occurring during or after

immunosuppressive therapy were enrolled in a retrospective study: 10 with

reactivation of overt HBV infection (overt group) and 13 of occult HBV infection

(occult group). Twenty-one patients were treated with nucleot(s)ide analogues

after HBV reactivation. Regimens including rituximab or fludarabine were

administered more frequently in the occult group (61% vs. 31%, respectively).

HBV reactivation was severe frequently in the overt (40%) and occult groups

(38.4%). Patients in the overt group showed higher HBV-DNA titers

(1.1 × 10(8)  ± 1.4 × 10(8) vs. 5.1 × 10(5)

 ± 6.8 × 10(5)  IU; P < 0.005). Seven patients died during HBV

reactivation, two in the overt and five in the occult group. Of these seven

patients, two remained untreated and five had been treated with Lamivudine; of

the 16 patients showing remission of HBV reactivation, four had been treated

with Lamivudine, four with Entecavir, two with Telbivudine, and six with

Lamivudine plus Adefovir. It is concluded that HBV reactivation is

life-threatening in patients with diseases inhibiting the immune response and/or

receiving immunosuppressive drugs. Supportive therapy without antiviral drugs or

Lamivudine monotherapy may not be effective for treating patients with HBV

reactivation.

J. Med. Virol. 83:1909-1916, 2011. © 2011 Wiley-Liss, Inc.

Copyright © 2011 Wiley-Liss, Inc.

PMID: 21915865 [PubMed - in process]

[Guest guest]

J Med Virol. 2011 Nov;83(11):1909-16. doi: 10.1002/jmv.22199. Epub 2011 Aug 23.

Reactivation of overt and occult hepatitis B infection in various

immunosuppressive settings.

Coppola N, Tonziello G, Pisaturo M, Messina V, Guastafierro S, Fiore M, Iodice

V, Sagnelli C, Stanzione M, Capoluongo N, Pasquale G, Sagnelli E.

Source

Department of Public Medicine, Section of Infectious Diseases, Second University

of Naples, Naples, Italy.

Abstract

The aim of the study was to evaluate clinical and virological differences in HBV

reactivation between patients with overt and occult HBV infection. Twenty-three

consecutive patients with symptomatic HBV reactivation occurring during or after

immunosuppressive therapy were enrolled in a retrospective study: 10 with

reactivation of overt HBV infection (overt group) and 13 of occult HBV infection

(occult group). Twenty-one patients were treated with nucleot(s)ide analogues

after HBV reactivation. Regimens including rituximab or fludarabine were

administered more frequently in the occult group (61% vs. 31%, respectively).

HBV reactivation was severe frequently in the overt (40%) and occult groups

(38.4%). Patients in the overt group showed higher HBV-DNA titers

(1.1 × 10(8)  ± 1.4 × 10(8) vs. 5.1 × 10(5)

 ± 6.8 × 10(5)  IU; P < 0.005). Seven patients died during HBV

reactivation, two in the overt and five in the occult group. Of these seven

patients, two remained untreated and five had been treated with Lamivudine; of

the 16 patients showing remission of HBV reactivation, four had been treated

with Lamivudine, four with Entecavir, two with Telbivudine, and six with

Lamivudine plus Adefovir. It is concluded that HBV reactivation is

life-threatening in patients with diseases inhibiting the immune response and/or

receiving immunosuppressive drugs. Supportive therapy without antiviral drugs or

Lamivudine monotherapy may not be effective for treating patients with HBV

reactivation.

J. Med. Virol. 83:1909-1916, 2011. © 2011 Wiley-Liss, Inc.

Copyright © 2011 Wiley-Liss, Inc.

PMID: 21915865 [PubMed - in process]

[Guest guest]

J Med Virol. 2011 Nov;83(11):1909-16. doi: 10.1002/jmv.22199. Epub 2011 Aug 23.

Reactivation of overt and occult hepatitis B infection in various

immunosuppressive settings.

Coppola N, Tonziello G, Pisaturo M, Messina V, Guastafierro S, Fiore M, Iodice

V, Sagnelli C, Stanzione M, Capoluongo N, Pasquale G, Sagnelli E.

Source

Department of Public Medicine, Section of Infectious Diseases, Second University

of Naples, Naples, Italy.

Abstract

The aim of the study was to evaluate clinical and virological differences in HBV

reactivation between patients with overt and occult HBV infection. Twenty-three

consecutive patients with symptomatic HBV reactivation occurring during or after

immunosuppressive therapy were enrolled in a retrospective study: 10 with

reactivation of overt HBV infection (overt group) and 13 of occult HBV infection

(occult group). Twenty-one patients were treated with nucleot(s)ide analogues

after HBV reactivation. Regimens including rituximab or fludarabine were

administered more frequently in the occult group (61% vs. 31%, respectively).

HBV reactivation was severe frequently in the overt (40%) and occult groups

(38.4%). Patients in the overt group showed higher HBV-DNA titers

(1.1 × 10(8)  ± 1.4 × 10(8) vs. 5.1 × 10(5)

 ± 6.8 × 10(5)  IU; P < 0.005). Seven patients died during HBV

reactivation, two in the overt and five in the occult group. Of these seven

patients, two remained untreated and five had been treated with Lamivudine; of

the 16 patients showing remission of HBV reactivation, four had been treated

with Lamivudine, four with Entecavir, two with Telbivudine, and six with

Lamivudine plus Adefovir. It is concluded that HBV reactivation is

life-threatening in patients with diseases inhibiting the immune response and/or

receiving immunosuppressive drugs. Supportive therapy without antiviral drugs or

Lamivudine monotherapy may not be effective for treating patients with HBV

reactivation.

J. Med. Virol. 83:1909-1916, 2011. © 2011 Wiley-Liss, Inc.

Copyright © 2011 Wiley-Liss, Inc.

PMID: 21915865 [PubMed - in process]

[Guest guest]

J Med Virol. 2011 Nov;83(11):1909-16. doi: 10.1002/jmv.22199. Epub 2011 Aug 23.

Reactivation of overt and occult hepatitis B infection in various

immunosuppressive settings.

Coppola N, Tonziello G, Pisaturo M, Messina V, Guastafierro S, Fiore M, Iodice

V, Sagnelli C, Stanzione M, Capoluongo N, Pasquale G, Sagnelli E.

Source

Department of Public Medicine, Section of Infectious Diseases, Second University

of Naples, Naples, Italy.

Abstract

The aim of the study was to evaluate clinical and virological differences in HBV

reactivation between patients with overt and occult HBV infection. Twenty-three

consecutive patients with symptomatic HBV reactivation occurring during or after

immunosuppressive therapy were enrolled in a retrospective study: 10 with

reactivation of overt HBV infection (overt group) and 13 of occult HBV infection

(occult group). Twenty-one patients were treated with nucleot(s)ide analogues

after HBV reactivation. Regimens including rituximab or fludarabine were

administered more frequently in the occult group (61% vs. 31%, respectively).

HBV reactivation was severe frequently in the overt (40%) and occult groups

(38.4%). Patients in the overt group showed higher HBV-DNA titers

(1.1 × 10(8)  ± 1.4 × 10(8) vs. 5.1 × 10(5)

 ± 6.8 × 10(5)  IU; P < 0.005). Seven patients died during HBV

reactivation, two in the overt and five in the occult group. Of these seven

patients, two remained untreated and five had been treated with Lamivudine; of

the 16 patients showing remission of HBV reactivation, four had been treated

with Lamivudine, four with Entecavir, two with Telbivudine, and six with

Lamivudine plus Adefovir. It is concluded that HBV reactivation is

life-threatening in patients with diseases inhibiting the immune response and/or

receiving immunosuppressive drugs. Supportive therapy without antiviral drugs or

Lamivudine monotherapy may not be effective for treating patients with HBV

reactivation.

J. Med. Virol. 83:1909-1916, 2011. © 2011 Wiley-Liss, Inc.

Copyright © 2011 Wiley-Liss, Inc.

PMID: 21915865 [PubMed - in process]