Reactivation of chronic hepatitis B infection following intensive chemotherapy and successful treatment with lamivudine: A case report and review of the literature

Background: Hepatitis B virus reactivation has been reported in cancer pati ents following administration of chemotherapy or immunosuppressive therapy and may result in liver damage of varying degrees of severity. Although tre atment is supportive in nature, lamivudine, a nucleoside analogue has been found to suppress HBV replication as evidenced by reports of 13 cases in th e medical literature. Patients and methods: We report a patient who achieved a successful outcome with lamivudine following reactivation of HBV during combination chemother apy for non-Hodgkin's lymphoma, and provide a brief overview of the literat ure including the 13 published case reports. Results: Lamivudine therapy resulted in clinical improvement as well as in normalization of liver function tests and coagulation profile. Conclusions: Lamivudine has been found to suppress HBV replication manifest ed both by histology and serum HBV-DNA levels in chronic carriers of HBV wh o developed reactivation of hepatic disease following chemotherapy. Physici ans caring for such patients should be able to recognize this clinical chal lenge, and lamivudine should be considered.