Reactivation of Hepatitis B Virus (Hbv) in Hbv-Resolved Patients with Adult T-Cell Leukemia/Lymphoma

Abstract

Background: Reactivation of hepatitis B virus (HBV) infection is generally known as a fatal complication in HBV-resolved patients with B-cell lymphoma who received rituximab-containing chemotherapy. However, there is little evidence regarding HBV reactivation in patients with adult T-cell leukemia/lymphoma (ATL). To evaluate the incidence and the characteristics of HBV reactivation in HBV-resolved patients with ATL, we performed this retrospective study in a single institution. Methods: Sixty-six patients who were diagnosed as ATL in our hospital between Jan 2005 and Jun 2013, were enrolled. Among HBsAg-negative patients at baseline, anti-HBc-positive and/or anti-HBs-positive were judged as having HBV-resolved infection. On regular HBV-DNA monitoring for HBV-resolved patients, HBV reactivation was defined as the detection of HBV-DNA levels. Results: Baseline HBV status was judged as follows: HBsAg-positive (3.0{%}, 2 of 66), HBsAg-negative (95.5{%}, 63 of 66), and no serological HBV assessment (1.5{%}, 1 of 66). Of 63 HBsAg-negative patients, 33 patients (52.4{%}) had HBV-resolved infection, and 26 of 33 patients underwent HBV-DNA monitoring. With median HBV-DNA follow-up of 238 days (range, 57 to 1420), HBV reactivation was observed in 3 (11.5{%}) of 26 HBV-resolved patients. All 3 reactivated patients were male, positive for both anti-HBc and anti-HBs at baseline, and received the LSG15 regimen as initial treatment. Anti-CCR4 monoclonal antibody, mogamulizumab was used in 2 patients before the occurrence of HBV reactivation. No hepatitis due to HBV reactivation occurred in those patients, who received antiviral drug immediately when HBV-DNA levels were detectable. Conclusions: The incidence of HBV reactivation was 11.5{%} among HBV-resolved patients with ATL. Regular monitoring of HBV-DNA is a reasonable strategy to prevent HBV-related hepatitis for those patients following systemic chemotherapy.