Reactivation of chronic hepatitis B virus infection by cancer chemotherapy

J. H. Hoofnagle, G. M. Dusheiko, D. F. Schafer, E. A. Jones, K. C. Micetich, R. C. Young, J. Costa

Research output: Contribution to journalArticlepeer-review

352 Scopus citations


Two patients referred for cancer chemotherapy were found to be chronic, asymptomatic hepatitis B surface antigen (HBsAg) carriers. They had normal serum aminotransferase levels, but their sera were positive for HBsAg and antibody to hepatitis B e antigen. Both patients developed acute, icteric hepatitis within 3 months of starting cycled chemotherapy. In both cases, the disease seemed to be caused by a recurrence of type B hepatitis; it was accompanied by a marked increase in HBsAg titer and the appearance of hepatitis B virus DNA and DNA polymerase in the serum. One patient had a second episode of acute hepatitis after a second course of chemotherapy, but both patients ultimately recovered and became seronegative for HBsAg. Thus, it seems that cancer chemotherapeutic agents can reactivate type B hepatitis in asymptomatic HBsAg carriers. This reactivation is most likely due to an increase in hepatitis B virus synthesis followed by a rebound in host immune responses to hepatitis B virus infection when therapy is stopped. Such a phenomenon could have important implications for the therapy of chronic hepatitis B virus infection.

Original languageEnglish (US)
Pages (from-to)447-449
Number of pages3
JournalUnknown Journal
Issue number4
StatePublished - 1982
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine

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