The combination of anti‑HBc and anti‑HBs levels is a useful predictor of the development of chemotherapy‑induced reactivation in lymphoma patients with resolved HBV infection

Matsubara,Tokuhiro; Nishida,Tsutomu; Shimoda,Akiyoshi; Shimakoshi,Hiromi; Amano,Takahiro; Sugimoto,Aya; Takahashi,Kei; Mukai,Kaori; Yamamoto,Masashi; Hayashi,Shiro; Nakajima,Sachiko; Fukui,Koji; Inada,Masami

doi:10.3892/ol.2017.7012

The combination of anti‑HBc and anti‑HBs levels is a useful predictor of the development of chemotherapy‑induced reactivation in lymphoma patients with resolved HBV infection

Authors:
- Tokuhiro Matsubara
- Tsutomu Nishida
- Akiyoshi Shimoda
- Hiromi Shimakoshi
- Takahiro Amano
- Aya Sugimoto
- Kei Takahashi
- Kaori Mukai
- Masashi Yamamoto
- Shiro Hayashi
- Sachiko Nakajima
- Koji Fukui
- Masami Inada
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Affiliations: Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560‑8565, Japan
Published online on: September 21, 2017 https://doi.org/10.3892/ol.2017.7012
Pages: 6543-6552
Copyright: © Matsubara et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Fatal chemotherapy‑induced hepatitis B virus reactivation (HBV‑R) is a well‑described serious complication observed in patients with lymphoma and resolved HBV infection. The aim of the present study was to determine the predictive factors of the development of chemotherapy‑induced HBV‑R. A total of 77 consecutive newly diagnosed patients with lymphoma and resolved HBV infection, who received chemotherapy from 2007 through 2015 were analysed retrospectively. Significant predictive factors associated with HBV‑R were identified based on the data from these patients. Ten patients developed HBV‑R during and following chemotherapy, and two of these 10 patients developed HBV‑associated hepatitis flares. There was a significant negative correlation between anti‑hepatitis B core (HBc) titres prior to chemotherapy and time to HBV‑R (P=0.016, R=‑0.732). Univariate and multivariate logistic regression analyses demonstrated that anti‑HBc and anti‑hepatitis B surface (HBs) titres at baseline were significant predictive factors for HBV‑R. In addition, patients with high anti‑HBc titres at baseline (above 10 S/CO) were significantly more likely to experience HBV‑R than patients with low anti‑HBc and high anti‑HBs titres (above 28 mIU/ml), who did not experience complete reactivation (P<0.0001). Furthermore, patients with low anti‑HBs titres were significantly more likely to experience HBV‑R than those with high anti‑HBs titres (P=0.031). All HBV‑R episodes among the patients with high anti‑HBc titres occurred within 3 months following the initiation of chemotherapy. The combination of anti‑HBc and anti‑HBs titres, as opposed to either titre alone, at baseline in patients with lymphoma may serve as a surrogate marker for the occurrence of HBV‑R under the influence of chemotherapy.

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