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Clinical and immunological aspects of hepatitis B virus infection in children receiving multidrug cancer chemotherapy

  • R. Repp
  • B. v. Hörsten
  • A. Csecke
  • J. Kreuder
  • A. Borkhardt
  • W. R. Willems
  • F. Lampert
  • W. H. Gerlich
Conference paper
Part of the Archives of Virology Supplementum book series (ARCHIVES SUPPL, volume 8)

Summary

For two reasons hepatitis B virus infection is an important problem in patients with cancer. First, multidrug cancer chemotherapy may reactivate or worsen a previously benign chronic HBV infection. Second, patients undergoing cancer chemotherapy are at an increased risk of acquiring and spreading HBV which may result in an endemic infection. HBV reactivation may precipitate into a severe acute disease including fulminant hepatitis. In contrast, the acquisition of HBV during cancer chemotherapy commonly takes a mild clinical course but frequently leads to persistently high viremia. This state of immunotolerance to viral antigens allows viral replication without any sign of liver cell destruction. Withdrawal of chemotherapy does not cause significant changes if infection occurred during cytotoxic chemotherapy. Infection with HBV during cancer chemotherapy, therefore, may be considered as a model of an induced antigen-specific immunotolerance. In agreement with this hypothesis, vaccination against HBV during cancer chemotherapy does not prevent spread of HBV in oncology wards as it does not produce significant anti-HBs titers. Furthermore, vaccination even suppresses the immune response to later booster doses after chemotherapy has been withdrawn.

Keywords

Cancer Chemotherapy Hepatitis Delta Virus Pediatric Oncology Unit Patient Undergo Cancer Chemotherapy Liver Cell Destruction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • R. Repp
    • 1
  • B. v. Hörsten
    • 1
  • A. Csecke
    • 1
  • J. Kreuder
    • 1
  • A. Borkhardt
    • 1
  • W. R. Willems
    • 2
  • F. Lampert
    • 1
  • W. H. Gerlich
    • 2
  1. 1.Department of PediatricsJustus-Liebig-UniversityGiessenFederal Republic of Germany
  2. 2.Department of Medical VirologyJustus-Liebig-UniversityGiessenFederal Republic of Germany

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