Preventive strategy of reactivation of hepatitis B virus at Kansai Medical University Hospital

Abstract

Background: Reactivation of hepatitis B virus (HBV) has been reported a fatal complication following systemic chemotherapy or other immunosuppressive therapy. Japanese Guidelines for hepatitis B reactivation was published in 2009. Although the guideline had been published, there were some reports of fulminant hepatitis B. It was suggested that the guideline had not been widespread yet. We investigated whether the guideline has been carried out in our hospital. Methods: We analyzed 591 patients who underwent chemotherapy in outpatient department at Kansai Medical University Hospital during November 2014. Results: Hepatitis B surface antigen (HBs Ag) was measured in 95.1{%}. The examination of Hepatitis B surface antibody (HBs Ab) and Hepatitis B core antibody (HBc Ab) were tested in 70.3{%}, but HBV-DNA quantitive test was examined only in 46.7{%}. This result revealed that the guideline had not been properly followed in our hospital. Then, we conducted educational activities to make physicians follow the guideline and reanalyzed how much compliance rates increased. The examination rate of HBs Ag increased from 95.1{%} to 95.6{%}. The rate of HBs and/or HBc Ab increased from 70.3{%} to 85.2{%}. The rate of DNA quantitive test increased from 46.7{%} to 49.5{%}. Conclusion: Educational activities improved compliance rates. Hepatitis B reactivation will increase because of the development of new drugs and the diversification of regimens. Immediate educational activity is needed to all physicians concerning chemotherapy..