Glucocorticoids and antivirals for HBV reactivation in onco-hematologic patients
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2010-02-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.mjhid.org/article/view/6547 |
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| author | Michela di Fonzo Andrea Marengo Alfredo Marzano Antonella Ferrari Bruno Monarca Gianfranco delle Fave Massimo Marignani |
| author_facet | Michela di Fonzo Andrea Marengo Alfredo Marzano Antonella Ferrari Bruno Monarca Gianfranco delle Fave Massimo Marignani |
| author_sort | Michela di Fonzo |
| collection | DOAJ |
| description | <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>14</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:ApplyBreakingRules /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> <w:UseFELayout /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; mso-hyphenate:none; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman"; mso-fareast-language:AR-SA;} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 2.0cm 2.0cm 2.0cm; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif] --><span style="font-size: 12pt; font-family: " lang="EN-US">Patients with inactive or occult hepatitis B virus infection and onco-hematological malignancies are at risk for hepatitis flare, hepatic failure and death due to </span><span style="font-size: 12pt; font-family: " lang="EN-US">chemotherapy-mediated reactivation. Nucleot(s)ide analogues can reduce reactivation risks and/or hepatitis. However, immuno-mediated phenomena concur to determine liver damage and clinical outcome. We describe two patients with onco-hematological and hepatitis B reactivation after chemotherapy in whom glucocorticoids were added to nucleot(s)ide. Antiviral therapy was effective on replication, while glucocorticoids managed hyperergic response. One patient without underlying liver disease survived, while the second died. In this later autopsy detected cirrhosis, not evident at presentation. This clinical experience suggests that in patients with <span>onco-hematological</span> and persistent liver function tests alterations in spite of effective antiviral response, glucocorticoids could control the effects of immune response. However prognosis and survival are related to the underlying liver status</span> |
| format | Article |
| id | doaj-art-73acf050024e4aedbaa4cd1dbd9e0e1a |
| institution | OA Journals |
| issn | 2035-3006 |
| language | English |
| publishDate | 2010-02-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-73acf050024e4aedbaa4cd1dbd9e0e1a2025-08-20T02:08:27ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062010-02-0121e2010035e2010035Glucocorticoids and antivirals for HBV reactivation in onco-hematologic patientsMichela di FonzoAndrea MarengoAlfredo MarzanoAntonella FerrariBruno MonarcaGianfranco delle FaveMassimo Marignani<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>14</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:ApplyBreakingRules /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> <w:UseFELayout /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; mso-hyphenate:none; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman"; mso-fareast-language:AR-SA;} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 2.0cm 2.0cm 2.0cm; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif] --><span style="font-size: 12pt; font-family: " lang="EN-US">Patients with inactive or occult hepatitis B virus infection and onco-hematological malignancies are at risk for hepatitis flare, hepatic failure and death due to </span><span style="font-size: 12pt; font-family: " lang="EN-US">chemotherapy-mediated reactivation. Nucleot(s)ide analogues can reduce reactivation risks and/or hepatitis. However, immuno-mediated phenomena concur to determine liver damage and clinical outcome. We describe two patients with onco-hematological and hepatitis B reactivation after chemotherapy in whom glucocorticoids were added to nucleot(s)ide. Antiviral therapy was effective on replication, while glucocorticoids managed hyperergic response. One patient without underlying liver disease survived, while the second died. In this later autopsy detected cirrhosis, not evident at presentation. This clinical experience suggests that in patients with <span>onco-hematological</span> and persistent liver function tests alterations in spite of effective antiviral response, glucocorticoids could control the effects of immune response. However prognosis and survival are related to the underlying liver status</span>http://www.mjhid.org/article/view/6547HBVhematologyhepatitis flarechemotherapy |
| spellingShingle | Michela di Fonzo Andrea Marengo Alfredo Marzano Antonella Ferrari Bruno Monarca Gianfranco delle Fave Massimo Marignani Glucocorticoids and antivirals for HBV reactivation in onco-hematologic patients Mediterranean Journal of Hematology and Infectious Diseases HBV hematology hepatitis flare chemotherapy |
| title | Glucocorticoids and antivirals for HBV reactivation in onco-hematologic patients |
| title_full | Glucocorticoids and antivirals for HBV reactivation in onco-hematologic patients |
| title_fullStr | Glucocorticoids and antivirals for HBV reactivation in onco-hematologic patients |
| title_full_unstemmed | Glucocorticoids and antivirals for HBV reactivation in onco-hematologic patients |
| title_short | Glucocorticoids and antivirals for HBV reactivation in onco-hematologic patients |
| title_sort | glucocorticoids and antivirals for hbv reactivation in onco hematologic patients |
| topic | HBV hematology hepatitis flare chemotherapy |
| url | http://www.mjhid.org/article/view/6547 |
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