A case of chronic HBV infection reactivation due to antineoplastic treatment

Some types of latent HBV infections may be reactivated due to the termination of immunosupression following antineoplastic treatment. A fulminant hepatic failure may also appear because of the liver damage. Our case was a 60 years-old male with HBsAg positivity for 15 years. He received a chemotherapy regimen for six months due to a pancreatic head carcinoma and complained about weakness, fatigue and jaundice after two weeks following the last period of chemotherapy. Physical examination showed only jaundice on skin and sclerae on admission to the Department of Infectious Diseases and Clinical Microbiology of Gulhane Military Medical Academy. Laboratory tests were as follows: erythrocyte sedimentation rate: 59 mm/h, (++) bilirubin in urine, AST: 1537 U/lt, ALT: 2089 U/lt, ALP: 133 U/lt, GGT: 174 U/lt, prothrombin time: 22 sec, ammonia in serum: 75 mmol/lt, HBsAg (+), HBeAg (-), anti-HBe (+), anti-HDV IgM (-), HDAg (+) and HBV DNA PCR (+) ( high copy). Based on these clinical and laboratory findings, the patient was diagnosed as " reactivation of chronic HBV infection" and underwent an antiviral treatment with lamivudine 2x150 mg/day. Many studies reporting similar cases have also recommended prophlactic lamivudine treatment to prevent the reactivation of chronic HBV infection during chemotherapy with antineoplastics.