Reactivation of replication of hepatitis B and C viruses after immunosuppressive therapy

An unresolved issue

Sandro Vento, Francesca Cainelli, Maria Serena Longhi

Research output: Contribution to journalReview article

106 Citations (Scopus)

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 languageEnglish
Pages (from-to)333-340
Number of pages8
JournalThe Lancet Oncology
Volume3
Issue number6
DOIs
Publication statusPublished - 2002
Externally publishedYes

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Immunosuppressive Agents
Hepatitis B virus
Hepacivirus
Chronic Hepatitis B
Poisons
Liver
Chronic Hepatitis C
Hepatitis B Surface Antigens
Drug-Related Side Effects and Adverse Reactions
Pharmaceutical Preparations
Hepatitis
Neoplasms
Therapeutics
Physicians
Transplants

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 journalReview article

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