Hepatitis B virus reactivation in hepatitis B virus surface antigen negative patients receiving immunosuppression: A hidden threat

Table 1 Characteristics and outcome of the ten hepatitis B surface antigen (-)/anti-hepatitis B virus core antibody (+)/anti-hepatitis B virus surface antigen (-) patients (at baseline) who experienced hepatitis B virus reactivation after immunosuppressive therapy

No.	Age, yr (at reactivation)	Sex	Disease	Type of IMS	Months from start of IMS to HBV reactivation	Months from last treatment cycle to diagnosis of HBV reactivation	HBV-DNA (IU/mL) at diagnosis of HBV reactivation	ALT/Bil/INR at diagnosis of HBV reactivation	Antiviral treatment	Serology at end of follow-up	Outcome
1	77	M	NHL	C, Flud, R	6	3	> 17857000	1472/3.22/1.3	Tenofovir	Anti-HBc (+)	Alive, response1
2	71	M	NHL	CHOP-R	8	1	487934	871/8.8/0.87	Entecavir	Anti-HBc (+)	Liver related death
3	74	M	NHL	C, Flud, R	6	1	1310000	73/0.7/0.97	Tenofovir	NA	Alive, response1
4	76	M	NHL	R	24	1	> 17857000	374/0.44/1.22	Entecavir	NA	Alive, response1
5	81	M	NHL	CHOP-R	30	12	660570	737/1/1.37	No treatment due to spontaneous seroconversion	Anti-HBc (+)/anti-HBs (+) 22 IU/L	Alive, response1
6	78	M	Castleman’s disease	P, R	12	1 (from last R cycle)	4228720	1536/15.8/1.03	Lamivudine	Anti HBc (+), anti- HBs (+) 189 IU/L	Non-liver related death
7	82	M	CLL	Chl, R, C	22	17 (from last R cycle)	> 17857000	3440/20.8/1.7	Tenofovir	HBsAg (+), anti-HBc (+), HBeAg (+)	Alive, response1
8	72	M	Temporal arteritis	P, MTX	6	0	> 17857000	308/0.63/1.03	Tenofovir	NA	Alive, response1
9	75	M	Dermatomyositis	P, MTX, AZA, Cyc	15	0	126992	657/1.47/0.86	Entecavir	Anti-HBc (+)/anti-HBe (+)	Alive, response1
10	53	M	Kidney transplantation	P, Cyc, Myc	48	0	> 17857000	28/0.96/0.98	Entecavir	HBsAg (+), anti-HBc (+), HBeAg (+)	Alive, response1
11	73	F	NHL	CHOP-R	9	4	127000	614/1.2/1.12	Lamivudine	Anti-HBc (+) anti-HBs (+) 183 IU/L	Liver related death
12	68	M	HL	ABVD, CHOP-R, DHAP, HSC transplantation, BEAM	28	16	> 17857000	49/1.1/1.01	Tenofovir	HBsAg (+), anti-HBc (+), HBeAg(+)	Alive, response1
13	77	M	Waldenstrom’s macroglobulinemia	C, R	36	3 (from last R cycle)	> 17857000	2500/19/1.19	Tenofovir	Anti-HBc (+)/anti-HBs (+) 579 IU/mL	Alive, response1
14	64	F	RA	MTX, R	24	2 (from last R cycle)	> 17857000	72/1.02/0.96	Entecavir	NA	Alive, response1

¹Clinical and biochemical response to antiviral treatment. HBV: Hepatitis B virus; HBc: Hepatitis B virus core antibody; HBsAg: Hepatitis B virus surface antigen; F: Female; M: Male; NHL: Non-Hodgkin lymphoma; CLL: Chronic lymphocytic leukemia; IMS: Immunosuppression; C: Cyclophosphamide; Flud: Fludarabin; R: Rituximab; CHOP-R: Cyclophosphamide Doxorubicin Vincristine Prednisone-Rednizolon; Chl: Chlorambucil; MTX: Methotrexate; AZA: Azathioprine; Cyc: Cyclosporine; Myc: Mycophenolate. NA: Not applicable.