Cancer patients who are hepatitis B surface antigen-positive should receive lamivudine therapy before undergoing chemotherapy to guard against the reactivation of their hepatitis B, according to a study reported in the December issue of Gastroenterology.

Hepatitis B virus reactivation is a serious cause of sickness and death in hepatitis B surface antigen-positive patients treated with chemotherapy, according to the study.

The researchers compared the effectiveness of early and deferred preemptive lamivudine therapy in reducing the incidence of hepatitis due to hepatitis B virus reactivation in hepatitis B surface antigen-positive lymphoma patients treated with chemotherapy.

The study involved 30 consecutive hepatitis B surface antigen-positive lymphoma patients undergoing intensive chemotherapy. The patients either received either 100 milligrams of lamivudine daily one week before chemotherapy or they had their lamivuidine treatment deferred until there was evidence of hepatitis B virus reactivation.

Fifty three percent of the patients who had lamivudine therapy deferred had their hepatitis B reactivated after undergoing chemotherapy, compared to none in the group receiving lamivudine before their chemotherapy began.

"Lamivudine should be considered preemptively before or at the initiation of chemotherapy for all hepatitis B surface antigen-positive lymphoma patients undergoing intense chemotherapy," concluded the researchers.

Gastroenterology. 2003 Dec; 125(6): 1742-9