Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Therap Adv Gastroenterol. 2012 Sep;5(5):359-70. doi: 10.1177/1756283X12450245.
Hepatitis B virus (HBV) reactivation is well documented in previously resolved or inactive HBV carriers who receive cancer chemotherapy. The consequences of HBV reactivation range from self-limited conditions to fulminant hepatic failure and death. HBV reactivation also leads to premature termination of chemotherapy or delay in treatment schedules. This review summarizes current knowledge of management of HBV reactivation in patients receiving cancer chemotherapy. HBV surface antigen (HBsAg) testing should be performed in patients who require cancer chemotherapy. Four meta-analyses support lamivudine prophylaxis for HBV reactivation during chemotherapy in HBsAg-positive patients. Randomized controlled trials to compare different HBV antiviral agents are needed to define optimal regimens for the prevention and treatment of HBV reactivation in patients receiving cancer chemotherapy.
乙型肝炎病毒 (HBV) 再激活在既往已缓解或无活动的 HBV 携带者中已有充分记录,这些携带者在接受癌症化疗时会发生 HBV 再激活。HBV 再激活的后果从自限性疾病到暴发性肝衰竭和死亡不等。HBV 再激活还会导致化疗提前终止或治疗计划延迟。这篇综述总结了目前在接受癌症化疗的患者中管理 HBV 再激活的知识。需要接受癌症化疗的患者应进行乙型肝炎表面抗原 (HBsAg) 检测。四项荟萃分析支持在 HBsAg 阳性患者中使用拉米夫定预防化疗期间的 HBV 再激活。需要进行随机对照试验来比较不同的乙型肝炎抗病毒药物,以确定用于预防和治疗接受癌症化疗的患者的 HBV 再激活的最佳方案。