Hepatitis B virus (HBV) reactivation during cytotoxic chemotherapy for cancer complicates treatment and can cause liver damage.
HBV reactivation occurs in to 10% and 50% of HBV carriers, however, risk factors are unclear.
In this study, doctors from Hong Kong assessed whether prechemotherapy HBV DNA levels influence HBV reactivation.
|The optimal cut-off was at a serum HBV DNA level of 3 x 105.|
|Journal of Viral Hepatitis|
The team evaluated 41 who underwent cytotoxic chemotherapy for breast cancer.
Of these patients, 17 developed reactivation and 24 did not.
The doctors developed a novel, ultra-sensitive, real-time PCR assay for the measurement of HBV DNA. The team measured the sera of 37 patients using this technique.
The team found that patients in the reactivation group had a significantly higher median HBV DNA load (1.03 x 106 copies/mL) than the nonreactivation group (<2.9 x 103 copies/mL).
The doctors calculated that the optimal cut-off between the 2 groups was at a serum HBV DNA level of 3 x 105. This gave a sensitivity of 81% and a specificity of 85%.
Dr Zhong's team concluded, "A high HBV viral load prior to the administration of cytotoxic chemotherapy is a significant predictive factor for the development of HBV reactivation".
"Such information may be useful in determining which patients would benefit most from prophylactic antiviral therapy during cytotoxic chemotherapy".