Hepatitis B virus reactivation and hepatitis in gastrointestinal cancer patients after chemotherapy

The objectives of this study were to investigate the incidences of hepatitis B virus (HBV) reactivation and hepatitis in gastrointestinal cancer patients with positive hepatitis B surface antigen (HBsAg) after chemotherapy and assess the effect of antiviral therapy on preventing HBV reactivation and hepatitis. The medical records of gastric or colorectal cancer patients with positive HBsAg undergoing chemotherapy in West China Hospital were reviewed from January 2009 to August 2014. One hundred and fifty-six patients were included. Seventy-six patients had no records of the baseline HBV DNA copy (bHDC) and received no antiviral therapy. Of 80 patients with known bHDCs, 39 patients received antiviral therapy. The incidence of HBV reactivation was 14.6 % in the non-antiviral group with known bHDCs (n = 41), compared with 0 % in the antiviral group (P = 0.039). Compared with 12.8 % in the antiviral group (P = 0.034), 29.9 % of patients suffered from hepatitis in the total non-antiviral group (n = 117). More patients with moderate/severe hepatitis were seen in the non-antiviral group (P = 0.027). Non-antiviral therapy was the only risk factor for hepatitis in multivariate analysis (HR 3.195, 95 % CI 1.117-10.989; P = 0.043). HBV reactivation and hepatitis occurred in a significant proportion of gastrointestinal cancer patients with positive HBsAg who received chemotherapy. Antiviral therapy could reduce the incidences of HBV reactivation and hepatitis.