3T for reactivation of chemo-treated HCC

liver411

[B]Epivir-HBV (lamivudine) Therapy for HBV Reactivation in a Patient Receiving Chemotherapy for Advanced Hepatocellular Carcinoma[/B]

Japanese researchers at Osaka City University describe a case of hepatitis B virus (HBV) reactivation that responded to lamivudine therapy in a 58-year-old man with advanced hepatocellular carcinoma (HCC). The case report appears in the May 2003 issue of Hepatology Research, the official journal of the Japanese Society of Hepatology.

After seroconversion of hepatitis B e antigen to e antibodies by interferon therapy, the patient was found to have HCC with a portal tumor thrombus. A transarterial port was placed in the right femoral artery to permit infusion of the chemotherapeutic agents epirubicin and cisplatin.

After 3 months of arterial chemotherapy, the serum alpha-fetoprotein level had decreased and tumor staining diminished. Laboratory examinations suggested a flare-up of hepatitis B. Epivir-HBV (lamivudine) was given to the patient for management of HBV reactivation.

After one month of lamivudine treatment, the serum HBV DNA level fell below the level of detection, and the alanine aminotransferase activity decreased to the normal range.

After additional arterial chemotherapy for HCC, no tumor staining was detected. Administration of lamivudine decreased serum HBV DNA levels for 7 months.

The researchers conclude, “Our findings suggest that HBV may be reactivated during chemotherapy for HCC, similar to other types of malignancies, and that lamivudine is effective for the management of HBV reactivation.”

Department of Hepatology, Osaka City University, Graduate School of Medicine, Osaka, Japan

06/16/03

Reference
A Tamori and others. Lamivudine therapy for hepatitis B virus reactivation in a patient receiving intra-arterial chemotherapy for advanced hepatocellular carcinoma. Hepatology Research 26(1): 77-80. May 2003.