Nakaya Aya, Fujita Shinya, Satake Atsushi, Nakanishi Takahisa, Azuma Yoshiko, Tsubokura Yukie, Hotta Masaaki, Yoshimura Hideaki, Ishii Kazuyoshi, Ito Tomoki, Nomura Shosaku
First Department of Internal Medicine, Kansai Medical University, Japan.
First Department of Internal Medicine, Kansai Medical University, Japan.
Leuk Res. 2016 Nov;50:46-49. doi: 10.1016/j.leukres.2016.09.014. Epub 2016 Sep 17.
Reactivation of hepatitis B virus (HBV) infection is a well-recognized and potentially fatal complication in patients treated with chemotherapy for lymphoid malignancies. Although several guidelines recommend antiviral prophylaxis and/or monitoring for HBV-DNA, there is no consensus over what time period these should occur. Clinically, we have encountered delayed reactivation of HBV infections and have reported 12 cases of reactivation in patients. Among them, five patients developed HBV reactivation more than a year after they completed their chemotherapy. This means there can be a delayed HBV reactivation and prolonged monitoring of more than a year after cessation of chemotherapy may be needed. Hence, the current recommendation of stopping antiviral prophylaxis 6-12 months after the cessation of chemotherapy may not fully protect all patients from HBV reactivation. The optimal duration of follow-up needs to be determined, and until better guidelines are set, there is no choice but to keep monitoring patients for reactivation for as long as practicable.
乙型肝炎病毒（HBV）感染再激活是接受化疗的淋巴系统恶性肿瘤患者中一种公认的且可能致命的并发症。尽管多项指南推荐进行抗病毒预防和/或监测HBV-DNA，但对于这些措施应在何时进行并无共识。临床上，我们遇到过HBV感染的延迟再激活情况，并报告了12例患者再激活病例。其中，5例患者在完成化疗一年多后出现HBV再激活。这意味着可能会出现延迟的HBV再激活，化疗结束后可能需要延长一年以上的监测时间。因此，目前关于化疗结束后6 - 12个月停止抗病毒预防的建议可能无法完全保护所有患者免受HBV再激活。需要确定最佳的随访时长，在制定出更好的指南之前，别无选择，只能尽可能长时间地持续监测患者是否再激活。
