Research Progress Of Breast Cancer Chemotherapy Related HBV Reactivation

Hepatitis B virus(HBV)in a latent or stationary state in breast cancer patients may be reactivated when receiving cytotoxic chemotherapy;the patients can even develop liver injury.Clinical manifestations include asymptomatic self-limiting hepatitis or fulminant hepatic failure leading to interruption of chemotherapy or death.According to the researches,in HBs Ag positive breast cancer patients with HBV reactivation,the rate of HBV reactivation accounts for 14.7% to 55.6%;the rate of hepatitis caused by HBV reactivation accounts for 16% to 58.8%;the rate of interruption of chemotherapy caused by HBV reactivation accounts for 12.7% to 71%.The pathogenesis of HBV reactivation is not yet fully explained,its generally considered by immune imbalance between HBV and host induced by chemotherapy drug.Moreover,it,s also related to the direct reactivation of HBV by chemotherapeutic drugs.The associated risk factors include HBV etiology state,HBV DNA loads,HBV covalently closed circular DNA loads,HBV gene mutation,HBsAg amino acid substitution and chemotherapy regimens,age,etc.HBV infection(HBsAg,HBcAg)should be routinely screened before chemotherapy to reduce the occurrence of breast cancer chemotherapy related HBV reactivation and related complications.HBsAg positive patients should prophylacticly use antiviral drugse(nucleotide(acid)analogue).HBsAg negative,and HBcAb positive patients should be closely followed up to early detect HBV reactivation and start the antiviral treatment.