Reactivation of Hepatitis B Virus among Malignancy Patients Undergoing Chemotherapy: A Prospective Cohort Study

Introduction:Reactivation of hepatitis B virus (HBV) can occur in patients receiving short-term chemotherapy, long-term immunosuppressive therapy, or disease-modifying antirheumatic agents for rheumatological diseases and is more common in hepatitis B surface antigen-positive patients. However, there is a lack of data for reactivation among malignant patients undergoing chemotherapy in resolved HBV patients. Methodology:A prospective cohort study of 200 oncological patients on chemotherapy was conducted for the reactivation of the HBV for a year. Patients underwent a thorough physical examination; baseline assessment and biochemical test and test were repeated at each follow-up. Results:The majority were females and in the 40-60-year age group. Age and serum albumin levels were significantly different (P < 0.05) among the reactivated versus the nonreactivated groups. Hepatitis B reactivation was seen in 14 (7%) patients with a maximum in the rituximab therapy group (11.26%). There was no statistically significant difference in baseline ALT levels between patients who experienced reactivation and those who did not. Conclusion:In the present study population, 7% had hepatitis B reactivation. The present study identifies old age, low serum albumin, and rituximab chemotherapy as significant risk factors for reactivation. Prophylactic antiviral therapy seems to be effective as no reactivation has occurred in this group.