Letters To The Editor
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2015; 21(35): 10251-10252
Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10251
Use of entecavir in hepatitis B virus reactivation of a patient with non-Hodgkin’s lymphoma
Hasan Tahsin Gozdas, Erkan Arpaci
Hasan Tahsin Gozdas, Department of Infectious Diseases and Clinical Microbiology, Dr. Münif İslamoğlu Kastamonu State Hospital, 37100 Kastamonu, Turkey
Erkan Arpaci, Department of Medical Oncology, Bülent Ecevit University Faculty of Medicine, 67980 Zonguldak, Turkey
Author contributions: Both authors contributed to this work.
Conflict-of-interest statement: The authors declare no conflict of interest related to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Hasan Tahsin Gozdas, Department of Infectious Diseases and Clinical Microbiology, Dr. Münif İslamoğlu Kastamonu State Hospital, 37100 Kastamonu, Turkey. dr.htgozdas@yahoo.com.tr
Telephone: +90-3662141053 Fax: +90-3662142427
Received: March 2, 2015
Peer-review started: March 4, 2015
First decision: April 13, 2015
Revised: April 21, 2015
Accepted: June 9, 2015
Article in press: June 9, 2015
Published online: September 21, 2015
Abstract

We read with interest the case report by Liu et al and the correspondence by Tuna et al regarding this case. Liu et al described hepatitis B virus (HBV) reactivation in a patient with non-Hodgkin’s lymphoma after withdrawal of lamivudine prophylaxis. When HBV reactivation was observed three months after lamivudine withdrawal, entecavir 0.5 mg daily was started. HBV DNA level was moderately elevated (104 copies/mL) at that time. So, we could not understand why a potent antiviral like entecavir was required for this case. In addition to this, entecavir must be used at a dose of 1 mg in patients with prior prophylactic treatment with lamivudine. As stated by Tuna et al duration of lamivudine prophylaxis in this case might be insufficient and HBV reactivation might have occured for this reason. So, we suppose that resolution of HBV reactivation might also be achieved with lamivudine instead of entecavir in this case.

Keywords: Immunochemotherapy, Hepatitis B reactivation, Antiviral prophylaxis, Lamivudine, Entecavir

Core tip: Lamivudine is used for the prevention of hepatitis B virus (HBV) reactivation in patients receiving immunochemotherapy. Following cessation of lamivudine prophylaxis, HBV reactivation can be observed because of insufficient duration of prophylaxis. If HBV DNA is moderately elevated at that moment, prophylaxis may be continued with lamivudine instead of entecavir.