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Treatment to Prevent Hepatitis B Virus Reactivation in Patients With Lymphoma Receiving Chemotherapy

Jihoon Baang, MD1
[+] Author Affiliations
1Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
JAMA. 2015;313(12):1269-1270. doi:10.1001/jama.2015.1438.
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To the Editor Dr Huang and colleagues1 showed the benefits of using a drug with a better resistance profile (entecavir) in preventing hepatitis B virus (HBV) reactivation in patients with lymphoma receiving chemotherapy who were seropositive for the hepatitis B surface antigen. Only 6.6% (n = 4) of patients experienced HBV reactivation in the entecavir group.

Entecavir has an extremely favorable resistance profile with only 1.2% of patients experiencing viral breakthrough due to resistance after 5 years of treatment.2 In addition, high HBV DNA levels have been associated with increased risk of resistance.2 Patients included in this study were both treatment naive and had a baseline HBV DNA titer of less than 1000 copies/mL, which is very low. Considering these baseline characteristics, the viral breakthrough rate of 6.6% seems higher than what would be expected.


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March 24, 2015
Tongyu Lin, MD; He Huang, MD; Xueying Li, MD
1Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
JAMA. 2015;313(12):1270. doi:10.1001/jama.2015.1444.
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