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Hepatitis B Virus

More than a third of the world's population has been infected with the hepatitis B virus (HBV), and it is estimated that between 350 and 400 million people globally are hepatitis B surface antigen (HBsAg) carriers. In Western countries, as a consequence of increasing immigration from highly endemic areas such as China, South -East Asia and Africa, the prevalence of chronic HBsAg carriers continues to rise.1 In Australia, the majority of HBV infected patients are from South-East Asia, North-East Asia and the Western Pacific regions.

HBV Reactivation
The majority of cases of HBV reactivation have been reported among patients who are HBsAg positive. However, patients who have had previous exposure to HBV infection (HBsAg negative but positive for the antibody to hepatitis core antigen, HBcAb) have also been reported to reactivate HBV infection.

Risk Factors For HBV Reactivation
High rates of reactivation have been reported in patients with high levels of pre-chemotherapy HBV DNA, steroid or anthracycline Ð containing regimens and a diagnosis of lymphoma or breast cancer.

Antiviral Prophylaxis For Patients with Chronic HBV Infection
A number of nucleos(t)ide analogues are currently approved for the treatment of chronic hepatitis B. The greatest experience in preventing HBV reactivation with cancer chemotherapy has been with lamivudine. Lamivudine is a reverse transcriptase inhibitor which results in rapid suppression of HBV replication.