Background Administration of immunosuppressive drugs can cause reactivation of hepatitis B virus (HBV), both asymptomatic and fulminant hepatitis. In July 2014, the Spanish Agency for Medicines and Health Products (AEMPS) published a press release in which it recommended screening for HBV before starting antineoplastic or immunosuppressive therapy. If HBV is detected in these patients, recommendations for prevention of HBV should be implemented.
Purpose To detect possible reactivation of HBV in patients previously treated with rituximab, doxorubicin and epirubicin.
Material and methods Retrospective study in pharmacy department of a tertiary hospital. All patients treated with rituximab, doxorubicin and epirubicin from September 2010 to September 2015 were collected in a database. On the other hand, active hepatitis B patients were treated in our hospital during the same period. Data were available from the Farmatools program.
Results 153 patients with hepatitis B treatment during the study period; of these, 3 patients were administered rituximab, 3 doxorubicin and none epirubicin. In the case of the 3 patients treated with rituximab, one had reactivated hepatitis B in 2012. Of the 3 patients treated with doxorubicin, one had reactivated hepatitis B at the time of administering the antineoplastic in 2013.
Conclusion These two patients were not screened before treatment with immunosuppressive and anticancer drugs; the two cases occurred before the information from AEMPS. Since the recommendation was made, AEMPS has increased HBV screening of patients who will be treated with these drugs, and there have been no cases of reactivation of hepatitis B subsequent to July 2014.
References and/or Acknowledgements
Sarrecchia C, Cappelli A, Aiello P. HBV reactivation with fatal fulminating hepatitis during rituximab treatment in a subject negative for HBsAg and positive for HBsAb and HBcAb. J Infect Chemother 2005;11:185-91
Álvarez Suárez B, Revilla Negro J de la, Ruiz-Antorán B, et al. Reactivación de la hepatitis B y su impacto clínico actual. Rev esp enferm dig (revista en la Internet) 2010(citado 2015 Oct 15);102:542-52. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082010000900006&lng=es
References and/or AcknowledgementsNo conflict of interest.
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