Incidence and characteristics of HBV reactivation in hematological malignant patients in south Egypt

Table 1 Characteristics of 53 patients with malignant hematologic disease who were negative for hepatitis B surface antigen n (%)

Characteristics	Total	Anti-HBc positive	Anti-HBc negative	P value
	(n = 53)	(n = 18)	(n = 35)
Age yr, mean ± SD	27.8 ± 26.2	34.4 ± 27.9	27.7 ± 25.4	0.42
Gender (male)	26 (49.1)	10 (55.6)	16 (45.7)	0.56
Diagnosis
Malignant lymphoma	26 (40.1)	9 (50.0)	17 (48.6)	1.00
Acute leukemia	25 (47.2)	9 (50.0)	15 (42.9)	0.77
Chronic leukemia	1 (1.9)	0 (0.0)	1 (2.9)	1.00
Multiple myeloma	1 (1.9)	0 (0.0)	1 (2.9)	1.00

Anti-HBc: Antibody to hepatitis B core antigen.

Table 2 Clinical and virological characteristics of patients who experienced hepatitis B reactivation

Characteristics	Case 1	Case 2	Case 3	Case 4	Case 5
Age (yr)/gender	79/F	8/M	11/F	5/M	20/M
Diagnosis	NHL (stage III)	AML	ALL	ALL	ALL
Treatment1	CVP	St Jude protocol	St Jude protocol	St Jude protocol	St Jude protocol
HBV serology and DNA prior to chemotherapy
HBsAg/anti-HBs/HBV DNA (log copy/mL)	(-)/(+)/1.8	(-)/(+)/negative	(-)/(-)/negative	(-)/(+)/negative	(-)/(nt)/negative
HBV reactivation months after anti-cancer therapy	12	4	5	6	4
HBV serology and DNA after chemotherapy
HBsAg/anti-HBs/HBV DNA (log copy/mL)	(+)/(nt)/7.6	(+)/(+)/5.8	(-)/(-)/3.1	(-)/(+)/2.9	(-)/(nt)/2.0
ALT (IU/mL)	35	195	27	86	17
Total bilirubin (mg/dL)	1	1.1	1.3	1.1	0.2
Outcome	Died	Died	Died	Alive	Alive
HBV genotype	D1	D1	D1	D1	D1
Core promoter mutation	Wild	T1764/G1766	A1764	Wild	-
Pre-core A1896	Mutant	Wild	Wild	Wild	-
Amino acid mutation in S gene product	P120S/S143L	P120T	-	T126I	-

M: Male; F: Female; NHL: Non-Hodgkin lymphoma; AML: Acute myeloid leukemia; ALL: Acute lymphoblastic leukemia; HBsAg: Hepatitis B surface antigen; Anti-HBs: Antibody to hepatitis B surface antigen; CVP: Cyclophosphamide, vincristine, prednisone; ALT: Alanine amino transferase enzyme.

¹St Jude protocol: (1) prephase: vincristine + steroid; (2) induction: vincristine + farmarabin + aracytine + etoposide, intrathecal; (3) consolidation: high dose methotrexate + mercaptopurine; (4) continuation: methotrexate + mercaptopurine.