Reactivatie van het hepatitis B-virus bij patiënten met een hematologische maligniteit

Reactivation of hepatitis B virus (HBV) is a potentially serious complication in patients with resolved or chronic HBV infection undergoing immunochemotherapy and/or stem cell transplantation (SCT) for haematological malignant disease.

HBV reactivation occurs in 11-86% of the patients with resolved HBV infection.

Risk factors for HBV reactivation include graft versus host disease, male sex, lymphoma, and long-term corticosteroid use.

In patients with chronic HBV infection, reactivation occurs at a higher rate (up to 85% of the cases).

The use of lamivudine as prophylaxis reduces the rate of HBV reactivation and HBV-related mortality.

The serological status of HBV should be determined for all patients who have to undergo immunochemotherapy or stem cell transplantation.

Patients with chronic HBV infection should always be treated prophylactically with a HBV replication inhibitor before immunosuppressive therapy is initiated. This prophylaxis can also be considered in the case of patients who have a resolved HBV infection and who must undergo prolonged immunosuppressive therapy.