Follow up of patients with chemotherapy plan due to solid organ malignancy in terms of hepatitis B infection

Hepatitis B infection can have many kinds of clinical manifestations such as HBV DNA replication along with the moderate increase in liver function tests, fulminant hepatitis or even may be death in immunecompromised patients. These situations may result in the delay of HBV diagnosis and treatment in such patients. The objective of this study is to screen all the patients with solid organ malignancy for HBV infection before their chemotherapy regimens, at Ege University Tülay Aktaş Oncology Hospital. Our purpose is to define the risk groups for HBV reactivation and thereafter start the lamivudine prophylaxis for eligible patients to prevent HBV reactivation and hepatitis during their follow up period. Two hundred and twenty five patients are included in our study. Patients are divided into 3 groups according to their serological results; Group I: past and recovered HBV infection: 43 patients (%19,1), Group II: isolated total anti-HBc positivity : 20 patients (%8,9) and Group III: chronic HBV infection with 10 patients (%4,4). In group I, there was no HBV reactivation and hepatitis. In group II, HBV reactivation developed in 1 (% 5,9) of 17 patients. In group II, occult HBV infection was found only in 1( %5,9) of 17 patients. Lamivudine prophylaxis was started to these two patients. In group III, we started lamivudine prophylaxis in 7 patients before their chemotherapy regimen. While under lamivudine prophylaxis 2(%28,6) of 7 patients developed HBV reactivation. During the follow up, neither hepatitis by reactivation of HBV nor HBV related death was observed in our study. In conclusion, in the moderate endemicity areas like our country for HBV infection, all patients must be screened for HBV serology before starting chemotherapy. We believe that, in the management of solid organ malignancy patients with HBV infection, the adoption of a multidisciplinary approach which includes Infectious Diseaseas and raising awareness among clinicians have vital importance for these patients.