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World J Gastrointest Oncol. Mar 15, 2012; 4(3): 37-45
Published online Mar 15, 2012. doi: 10.4251/wjgo.v4.i3.37
Patients with hematological malignancies and serological signs of prior resolved hepatitis B
Massimo Marignani, Elia Gigante, Paola Begini, Alfredo Marzano, Michela di Fonzo, Ilaria Deli, Sara Gallina, Maria Christina Cox, Gianfranco Delle Fave
Massimo Marignani, Elia Gigante, Paola Begini, Michela di Fonzo, Ilaria Deli, Sara Gallina, Gianfranco Delle Fave, Digestive and Liver Disease Department, School of Medicine and Psychology University “Sapienza”, Azienda Ospedaliera S. Andrea, Via Grottarossa, 1035-1039, 00189 Rome, Italy
Maria Christina Cox, Haematology Department, School of Medicine and Psychology University “Sapienza”, Azienda Ospedaliera S. Andrea, Via Grottarossa, 1035-1039, 00189 Rome, Italy
Alfredo Marzano, SCDU of Gastroenterology and Hepatology AO San Giovanni Battista Corso Bramante 88, 10125 Torino, Italy
Author contributions: Marignani M, Gigante E, Gallina S and Deli I performed the research; Marignani M, di Fonzo M and Begini P analyzed the data; Marzano A and Marignani M developed the concept and designed the paper; Marignani M and Delle Fave G drafted and revised the paper; Marignani M and Cox MC wrote the paper.
Correspondence to: Massimo Marignani, MD, Digestive and Liver Disease Department, Biliary Tract and Liver Disease Section, School of Medicine and Psychology University “Sapienza”, Azienda Ospedaliera Sant’Andrea Via Grottarossa, 1035-1039, 00189 Rome, Italy. mmarignani@hotmail.com
Telephone: +39-6-33775691 Fax: +39-6-33775526
Received: May 5, 2011
Revised: October 4, 2011
Accepted: October 12, 2011
Published online: March 15, 2012
Abstract

Hepatitis B virus (HBV) infection affects a large part of the world population. Within the different virological HBV categories that have been identified, patients with occult HBV infection represent a peculiar group. These individuals harbor a replication competent virus, inhibited in its replicative function. Accordingly, cases of reactivations have been observed in immunosuppressed individuals who lose immunological control over the infection. Patients with hematological malignancies (HM) are treated with intense myelo- and immunosuppressive chemotherapy regimens which favor HBV reactivation. This event can have severe consequences, such as hepatitis flare, hepatic failure and even death. In addition, it can lead to delays or interruptions of curative treatments, resulting in a decreased disease free and overall survival. In this review, we will examine the event of HBV reactivation in patients with signs of resolved HBV infection undergoing treatment for HM and propose possible management strategies.

Keywords: Occult hepatitis B; Hematological malignancies; Hepatitis B virus; Chemotherapy; Hepatitis B reactivation