Hepatitis B and C Reactivation in Chemotherapy Treated Patients

Hepatitus B and C virus reactivation is a well described complication in cancer patients who receive cytotoxic chemotherapy and may result in varying degrees of liver damagePatients and methods:A total of 60 consecutive patients with hematological malignancies(16 had NHL(26.6%),5 had HL(8.3%),15 had ALL(25%),5 had AML(8.3%),10 had CML (16.7%),4 had CLL(6.7%) and 5 had MM (8.3%).were included in our study.Based on serum markers testing for HBV and HCV , patients were classified into 2 groups:Group(A):included 29 patients :23 have HCV AB positive,4 have HBsAg positive and 2 have HBsAg negative with HBcAb positive.Group(B):included 31 patients have viral markers negative.There were 31 males (51.7%) and 29 females( 48.3%).their ages ranged from 12-75 y with mean 40.4±16.7 y include 23 patients have HCV Ab positive (38.3%) 4 patients have overt HBV(6.7%) and 2 patients have occult HBV infection(3.3%).Results:There were 12 cases developed hepatitis flare-up ;8 patients of group (A) where 4 due to HBV(50%),2 due to HCV(25%),one patient due to hepatotoxicity of chemotherapy(12.5%) and one patient due to malignant infiltration (12.5%).Fare up due to hepatotoxicity of chemotherapy is the most common causes of flare up in group(B) that include 2 patients (50%) followed by occult HBV reactivation and occult HCV reactivation each include one patient (25%).HBV patients are at high risk to develop hepatitis reactivation in comparison to HCV patients where 5 patients out of 6 (85%)developed hepatitis reactivation mean while only 3 HCV patients out of 23 (13%) developed reactivation.Hepatitis flare occur mostly during treatment of NHL (50%) 4 patients of group A and 2 patients of group B , followed by other hematological malignancies.Hepatitis flare occur mostly during CHOP Chemotherapy (50%) 4 patients of group A have NHL and 2 patients of group B have NHL , followed by other chemotherapies.HBV reactivation rate of around 83.3% in patients receiving conventional glucocorticoids -containing systemic chemotherapy.HBV reactivation occurred mainly in male patients about(75%)9 patients out of 12 whereas (25%)3 patients were female.