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Hepatitis virus reactivation in canc...

Yeo, Winnie.

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Hepatitis virus reactivation in cancer patients undergoing cytotoxic chemotherapy: Incidences, associated factors and management.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Hepatitis virus reactivation in cancer patients undergoing cytotoxic chemotherapy: Incidences, associated factors and management./
作者:	Yeo, Winnie.
面頁冊數:	256 p.
附註:	Adviser: P. J. Johnson.
Contained By:	Dissertation Abstracts International63-05B.
標題:	Health Sciences, Medicine and Surgery. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3052092
ISBN:	0493675590

Hepatitis virus reactivation in cancer patients undergoing cytotoxic chemotherapy: Incidences, associated factors and management.
Yeo, Winnie.

Hepatitis virus reactivation in cancer patients undergoing cytotoxic chemotherapy: Incidences, associated factors and management. - 256 p.

Adviser: P. J. Johnson.

Thesis (M.D.)--Chinese University of Hong Kong (People's Republic of China), 2001.

Chronic hepatitis B virus (HBV) infection is endemic in many parts of the world including Hong Kong. HBV reactivation is a well-described and potentially fatal complication in cancer patients who receive cytotoxic chemotherapy. The reactivation is characterized by raised levels of serum HBV DNA, abnormal liver function tests and clinical hepatitis of varying severity. The aims of this thesis were firstly to determine the frequency of HBV reactivation in cancer patients undergoing cytotoxic chemotherapy and to identify the associated risk factors, and secondly to address treatment strategies that can be administered to patients in preventing and controlling the severity of this condition. The following studies have been conducted for these objectives. In a prospective study, patients who were HBsAg positive were followed up during their course of chemotherapy. HBV reactivation was found to occur in nearly 20% of them and accounts for 44% of hepatitis cases. Factors associated with the development of HBV reactivation included male gender, young age, HBeAg positivity and a diagnosis of lymphoma. In two separate studies, the role of HBV mutants in HBeAg-negative HBV reactivation were assessed. Chronic HBV carriers who were HBeAg negative/anti-HBe positive with nt 1896 mutation (G to A) appeared to be more likely to develop HBV reactivation during cytotoxic chemotherapy, and the latter did not appear to associate with the emergence of mutant HBV. With respect to the treatment of HBV reactivation, the use of anti-viral agent, lamivudine, was found to associate with HBV DNA suppression, although the delay in the administration of the anti-viral could still be associated with poor outcome. When lamivudine was administered prior to the commencement of chemotherapy, the incidence and the severity of HBV reactivation in cancer patients undergoing chemotherapy appeared to be reduced. It was concluded that for 20% of HBV carriers developed HBV reactivation during cytotoxic chemotherapy, and the associated risk factors included male gender, young age, HBeAg seropositivity, mutant HBV and a diagnosis of lymphoma. Use of lamivudine appeared to be effective in controlling the condition.

ISBN: 0493675590Subjects--Topical Terms:

1017756
Health Sciences, Medicine and Surgery.

Hepatitis virus reactivation in cancer patients undergoing cytotoxic chemotherapy: Incidences, associated factors and management.
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