Screening and evaluation of chronic and occult Hepatitis B in chemo – radiotherapy patients with cancer

Abstract

Background:Hepatitis B virus infection (HBV) and its complications is one of the most serious problems of the health system in many parts of the world. In the present study, we will assess chronic and occult HBV and isolated anti-Hepatitis B core antigen whose screening and evaluation is not routine in different populations.Materials and Methods:This descriptive analytical study was conducted on 213 patients undergoing chemotherapy - radiotherapy referred to the hematology - oncology clinics of Isfahan, Iran in 2012. In order to determine the serum levels of hepatitis B surface antigen (HbSAg), Hepatitis B Antigen and Antibody (HBCAb), aspartate aminotransferase (AST), alanine transaminase (ALT) and Alkaline phosphatase (ALK.P), venous blood samples were obtained. If the HBCAb sample was positive, another sample of the serum was sent to the laboratory to perform polymerase chain reaction and to determine viral load.Results:The mean age of the patients was 47.7 ± 9 years, with an age range of 27 -73 years; 98 (46%) and 115 (54%) cases were male and female, respectively, with mean age of 51.9 ± 8.3 and 44.1 ± 8.1 years, and there was no significant difference (P < 0.001). The mean level of liver enzymes including AST, ALT and ALK.P were 34.2 ± 36.02, 38.9 ± 47.1 and 252.1 ± 234.7, respectively. Two cases were HbSAg positive (0.9%) and six cases were HBCAb positive (2.8%) and HbSAg negative. Three cases had a high viral load at the rate of starting treatment among positive anti-HBC patients.Conclusion:Because occult hepatitis is investigated less commonly in routine studies, it seems that screening and evaluating its prevalence is useful in the management of patients.

Update on occult hepatitis B virus infection

“…While the screening of HBV by the NAT is expensive, it is effective in reducing the transmission of OBI via blood transfusion and blood products[ 89 , 90 ]. The detection of anti-HBc is a good test for OBI tracking, but it accounts for about 80% of OBI cases[ 97 , 98 ]. Thus, with regard to what was stated previously the implementation of anti-HBc test for blood donors can be considered a second safeguard policy for reducing the transmission of HBV via blood transfusion[ 99 , 100 ], although NAT is more sensitive and effective than serological HBsAg test as a preventive measure for HBV or OBI transmission via blood transfusion.…”

Onkoloji Hastalarında Kemoterapi öncesi HBs Ag, AntiHBs ve izole AntiHBc pozitiflik oranları

“…İran'dan Meidani ve ark'nın [8] hematolojionkoloji kliniğinde, kemoterapi ve radyoterapi alacak 213 hasta ile yürüttüğü, yaş ortalaması 47,7 yıl ve %54'ü erkek olan bir çalışmada hastalarda sıklık sırasıyla meme, gastrointestinal tümör, baş-boyun tümörü ve lenfoma (sırasıyla %29,1; %19,7; %13,6 ve %6,6) olduğu belirlenmiştir. Toplam 213 olgudan 2'sinde (%0,9) HBsAg pozitifliği tespit edildiği, %2,8 (6/213) olguda ise izole antiHBc pozitifliği olduğu belirlenmiştir [8]. İnci ve ark.…”