Eur Rev Med Pharmacol Sci 2014; 18 (23): 3629-3631

Glioblastoma multiforme and hepatitis B: do the right thing(s)

F. Purchiaroni, P. Begini, G. Minniti, S. Gallina, G. Delle Fave, M. Marignani

Department of Digestive and Liver Disease, School of Medicine and Psychology, Sapienza University, Azienda Ospedaliera S. Andrea, Rome, Italy. flaminia.purchiaroni@hotmail.it


OBJECTIVE: Hepatitis B virus (HBV) reactivation is a well-known complication related to immunosuppression.
Clinical manifestations of HBV relapse range from self-limiting anicteric hepatitis to acute hepatic failure.
Temozolomide (TMZ) is an alkylating agent used for the treatment of glioblastoma multiforme (GBM), the most common and deadliest of malignant primary brain tumors.

CASE REPORT: We report the case of a 52-year old man with a history of serological positivity for hepatitis B surface antigen (HBsAg) who was diagnosed with GBM. Since the tumor was multifocal and thus inoperable, the patient received radiotherapy with concomitant TMZ and corticosteroids, without a prophylactic therapy for HBV infection. Acute hepatitis developed five months later the beginning of anticancer therapy. We started antiviral entecavir, which led to a decrease of HBV-DNA titer to 20 IU/ml, allowing the prosecution of the TMZ therapy.

CONCLUSIONS: Up to now only four other cases of HBV relapse during TMZ therapy have been reported in literature. These cases underline the need of HBV screening and antiviral prophylaxis before starting TMZ administration.

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To cite this article

F. Purchiaroni, P. Begini, G. Minniti, S. Gallina, G. Delle Fave, M. Marignani
Glioblastoma multiforme and hepatitis B: do the right thing(s)

Eur Rev Med Pharmacol Sci
Year: 2014
Vol. 18 - N. 23
Pages: 3629-3631