Abstract
The liver is susceptible to the toxic effects of many cytotoxic or immunosuppressive treatments. However, in carriers of hepatitis B virus (HBV) and, less frequently, of hepatitis C virus, liver damage due to reactivation of viral replication can occur after withdrawal of immunosuppressive drugs. These reactivations, which are associated with fulminant forms of hepatitis in up to 25% of cases, are observed both in symptom-free chronic carriers of hepatitis B surface antigen and in patients who have chronic hepatitis B or C and concurrent haematological tumours or solid neoplasms or who have received transplants. HBV-related complications may cause delays or modifications of therapy, and the chance of cure is reduced. In this review, we analyse clinical, biochemical, and serological issues in reactivation of viral replication and examine the role of immune reactions in the pathogenesis and the possible toxicity of immunosuppressive drugs. We emphasise the importance of identifying predictive markers of a clinically relevant reactivation, review difficulties in drug prevention and treatment, indicate studies that are needed to address the key clinical issues, and give practical recommendations to practising physicians and oncologists.
| Original language | English |
|---|---|
| Pages (from-to) | 333-340 |
| Number of pages | 8 |
| Journal | The Lancet Oncology |
| Volume | 3 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2002 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Oncology
Cite this
Reactivation of replication of hepatitis B and C viruses after immunosuppressive therapy : An unresolved issue. / Vento, Sandro; Cainelli, Francesca; Longhi, Maria Serena.
In: The Lancet Oncology, Vol. 3, No. 6, 2002, p. 333-340.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Reactivation of replication of hepatitis B and C viruses after immunosuppressive therapy
T2 - An unresolved issue
AU - Vento, Sandro
AU - Cainelli, Francesca
AU - Longhi, Maria Serena
PY - 2002
Y1 - 2002
N2 - The liver is susceptible to the toxic effects of many cytotoxic or immunosuppressive treatments. However, in carriers of hepatitis B virus (HBV) and, less frequently, of hepatitis C virus, liver damage due to reactivation of viral replication can occur after withdrawal of immunosuppressive drugs. These reactivations, which are associated with fulminant forms of hepatitis in up to 25% of cases, are observed both in symptom-free chronic carriers of hepatitis B surface antigen and in patients who have chronic hepatitis B or C and concurrent haematological tumours or solid neoplasms or who have received transplants. HBV-related complications may cause delays or modifications of therapy, and the chance of cure is reduced. In this review, we analyse clinical, biochemical, and serological issues in reactivation of viral replication and examine the role of immune reactions in the pathogenesis and the possible toxicity of immunosuppressive drugs. We emphasise the importance of identifying predictive markers of a clinically relevant reactivation, review difficulties in drug prevention and treatment, indicate studies that are needed to address the key clinical issues, and give practical recommendations to practising physicians and oncologists.
AB - The liver is susceptible to the toxic effects of many cytotoxic or immunosuppressive treatments. However, in carriers of hepatitis B virus (HBV) and, less frequently, of hepatitis C virus, liver damage due to reactivation of viral replication can occur after withdrawal of immunosuppressive drugs. These reactivations, which are associated with fulminant forms of hepatitis in up to 25% of cases, are observed both in symptom-free chronic carriers of hepatitis B surface antigen and in patients who have chronic hepatitis B or C and concurrent haematological tumours or solid neoplasms or who have received transplants. HBV-related complications may cause delays or modifications of therapy, and the chance of cure is reduced. In this review, we analyse clinical, biochemical, and serological issues in reactivation of viral replication and examine the role of immune reactions in the pathogenesis and the possible toxicity of immunosuppressive drugs. We emphasise the importance of identifying predictive markers of a clinically relevant reactivation, review difficulties in drug prevention and treatment, indicate studies that are needed to address the key clinical issues, and give practical recommendations to practising physicians and oncologists.
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UR - http://www.scopus.com/inward/citedby.url?scp=0036077794&partnerID=8YFLogxK
U2 - 10.1016/S1470-2045(02)00773-8
DO - 10.1016/S1470-2045(02)00773-8
M3 - Review article
VL - 3
SP - 333
EP - 340
JO - The Lancet Oncology
JF - The Lancet Oncology
SN - 1470-2045
IS - 6
ER -