Successful treatment with lamivudine in two patients with severe reactivation of hepatitis B virus infection after withdrawal of chemotherapy

Reactivation of chronic infection is a serious complication during and espe cially after the withdrawal of cancer chemotherapy in hepatitis B virus car riers. Mortality is high, rang,ng From 4 to 20%. We report two cases of sev ere reactivation, after withdrawal of chemotherapy for chronic lymphocytic leukemia in one case and for a bladder tumor in the other. Recovery occurre d with lamivudine therapy Morbidity and mortality are common in these cases , especially when intensive chemotherapy and/or chronic hepatitis and/or pr ecore mutants viruses are involved. Although lamivudine seems to be effecti ve in these cases, prophylactic use has not been clearly defined and must b e evaluated.