Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Hepatol. Jul 27, 2013; 5(7): 387-392
Published online Jul 27, 2013. doi: 10.4254/wjh.v5.i7.387
Hepatitis B virus reactivation in hepatitis B virus surface antigen negative patients receiving immunosuppression: A hidden threat
Kalliopi Zachou, Alexandros Sarantopoulos, Nikolaos K Gatselis, Themistoklis Vassiliadis, Stella Gabeta, Aggelos Stefos, Asterios Saitis, Panagiota Boura, George N Dalekos
Kalliopi Zachou, Nikolaos K Gatselis, Stella Gabeta, Aggelos Stefos, Asterios Saitis, George N Dalekos, Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, 41110 Larissa, Greece
Alexandros Sarantopoulos, Panagiota Boura, Clinical Immunology Unit, 2nd Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
Themistoklis Vassiliadis, First Medical Propedeutic Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital Thessaloniki, 54636 Thessaloniki, Greece
Author contributions: Zachou K, Boura P and Dalekos GN had the original idea, designed and wrote the study protocol; Sarantopoulos A, Gatselis NK, Vassiliadis T and Gabeta S along with Zachou K and Dalekos GN made the laboratory work, collected and summarized the data as well as treated and followed the patients; Zachou K analyzed and interpreted the final data of the patients, and along with Boura P and Dalekos GN wrote the first draft of the manuscript; Zachou K, Vassiliadis T, Boura P and Dalekos GN made the final critical revision of the manuscript for important intellectual content; all authors approved the final version of the manuscript.
Correspondence to: George N Dalekos, MD, PhD, Professor, Head, Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, Biopolis, 41110 Larissa, Greece. dalekos@med.uth.gr
Telephone: +30-241-3502285 Fax: +30-241-3501557
Received: March 15, 2013
Revised: May 3, 2013
Accepted: June 8, 2013
Published online: July 27, 2013
Processing time: 34 Days and 23.6 Hours
Core Tip

Core tip: Patients with occult or resolved hepatitis B undergoing chemotherapy or immunosuppression are potentially at risk of hepatitis B virus (HBV) reactivation which can be disastrous since it can lead to acute liver failure and death. In this report, we describe the characteristics and outcome in one of the larger series of patients (n = 14) with occult or resolved HBV who experienced HBV reactivation after receiving immunosuppression though they were initially HBV surface antigen-negative. Most of patients had received rituximab. We showed that these patients can develop severe HBV reactivation even 2 years after stopping immunosuppression, whereas prompt antiviral treatment on diagnosis of reactivation can be lifesaving.