ABSTRACT Reactivation of Hepatitis B virus causing liver damage is a concern in patients with chronic HBV infections who receive immunosuppressive or cytotoxic treatments. HBV screening should be considered for all patients going to receive immunosuppressive regimens which have the potential to induce reactivation of HBV infection. We discuss here a case of occult Hepatitis B flare after chemotherapy in a patient who had negative acute hepatitis profile including HBsAg prior to therapy and baseline serum AST, ALT, INR, albumin, bilirubin and serum creatinine were within normal limits.
Cite this paper
nullS. Ahmad, V. Le and T. Ali, "Occult Hepatitis B Flare-up after Chemotherapy Treatment in HBsAg Negative Patient," International Journal of Clinical Medicine, Vol. 2 No. 5, 2011, pp. 621-623. doi: 10.4236/ijcm.2011.25103.
 C. L. Lai, V. Ratziu and M. F. Yuen, T Poynard, “Viral Hepatitis B,” Lancet, Vol. 362, 2003, pp. 2089-2094.
 R. P. Perrillo, “Acute Flares in Chronic Hepatitis B: The Natural and Unnatural History of an Immunologically Mediated Liver Disease,” Gastroenterology, Vol. 120, No. 4, 2001, pp. 1009-1022.
 G. Rossi, A. Pelizzari, M. Motta and M. Puoti, “Primary Prophylaxis with Lamivudine of Hepatitis B Virus Reactivation in Chronic HbsAg Carriers with Lymphoid Malignancies Treated with Chemotherapy,” British Journal of Haematology, Vol. 115, No. 1, 2001, pp. 58-62.
 M. Mondelli, G. M. Vergani, A. Alberti, et al., “Specificity of T Lymphocyte Cytotoxicity to Autologous Hepatocytes in Chronic Hepatitis B Virus Infection: Evidence That T Cells Are Directed against HBV Core Antigen Expressed on Hepatocytes,” The Journal of Immunology, Vol. 129, No. 6, 1982, pp. 2773-2778.
 S. J. Leaw, C. J. Yen, W. T. Huang, T. Y. Chen and W. C. Su, C. J. Tsao, “Preemptive Use of Interferon or Lamivudine for Hepatitis B Reactivation in Patients with Aggressive Lymphoma Receiving Chemotherapy,” Annals of Hematology, Vol. 83, No. 5, 2004, pp. 270-275.
 C. Blanpain, C. Knoop, M. L. Delforge, et al., “Reactivation of Hepatitis B after Transplantation in Patients with Pre-Existing Anti-Hepatitis B Surface Antigen Antibodies,” Transplantation, Vol. 66, No. 7, 1998, pp. 883-886.
 I. Cacciola, T. Pollicino, G. Squadrito, et al., “Occult hepatitis B Virus Infection in Patients with Chronic Hepatitis C Liver Disease,” The New England Journal of Medicine, Vol. 341, No. 1, 1999, pp. 22-26.
 W. Yeo, P. K. S Chan, S. Zhong, et al., “Frequency of Hepatitis B Virus Reactivation in Cancer Patients Undergoing Cytotoxic Chemotherapy: A prospective Study of 626 Patients with Identification of Risk Factors,” Journal of Medicine Virology, Vol. 62, No. 3, 2000, pp. 299- 307.
 A. S. F. Lok, R. H. S. Liang, E. K. W. Chiu, et al., “Reactivation of Hepatitis B Virus Replication in Patients Receiving Cytotoxic Therapy. Report of a Prospective Study,” Gastroenterology, Vol. 100, No. 1, 1991, pp. 182- 188.
 W. Yeo and P. J. Johnson, “Diagnosis, Prevention and Management of Hepatitis B Virus Reactivation during Anticancer Therapy,” Hepatology, Vol. 43, No. 2, 2006, pp. 209-220. doi:10.1002/hep.21051
 W. Yeo, P. K. S. Chan, W. M. Ho, et al. “Lamivudine for the Prevention of Hepatitis B Virus Reactivation in HBV Seropositive Cancer Patients Undergoing Cytotoxic Chemotherapy,” Journal of Clinical Oncology, Vol. 22, No. 5, 2004, pp. 927-934.
 G. K. K. Lau, H. H. Y. Yiu, D. Y. T. Fong, et al., “Early is Superior to Deferred Preemptive Lamivudine Therapy for Hepatitis B Patients Undergoing Chemotherapy,” Gastrterology, Vol. 125, No. 6, 2003, pp. 1742-1749.