Impact of immunosuppression and chemotherapy on reactivation of viral hepatitis

Abstract EN

Chemotherapy drugs, biological medications that are used to treat cancer, may cause hepatic side effects.

Patients with pre-existing viral hepatitis may be more susceptible to exacerbation of their underlying liver disease, and risk of drug-induced hepatotoxicity.

We conducted a search on immunosuppression, and its impact on reactivation of viral hepatitis, using the electronic medical databases.

Before starting chemotherapy, it is recommended to record the past history of liver disease and check for hepatitis B virus (HBV) and hepatitis C virus (HCV) serology.

In immunosuppressed patients, radiation toxicity, graft versus host disease, hepatic veno-occlusive disease, acalculous cholecystitis, tumor infiltration, ischemia, other viruses such as CMV and herpes virus, and systemic infection should also be considered.

Transplant recipients with serologic evidence of previous infection with hepatitis B or C, or those who receive organs from a seropositive donor, should have viral load levels monitored before and after transplantation and, may also require treatment.

We believe that there is a role for prophylactic use of antiviral treatment in patients at risk for HBV reactivation.