Abstract

Acute hepatitis B (AHB) results 90% in spontaneous healing and often does not require antiviral therapy. It may rarely result in severe liver damage as fulminant hepatitis. The possibility of fulminant hepatitis is high in immunosuppressed patients than in immunocompetent patients. Although the exact cause is unexplained, immunosuppression associated with chemotherapy may increase the possibility of fulminant hepatitis by increasing hepatitis B virus replication in immunosuppressed patients. According to this hypothesis, in immunosuppressed patients with AHB, maintaining viral load suppression with lamivudine therapy may cause less host response and may be effective in preventing risk of fulminant hepatitis. A case in which AHB developed while receiving maintenance chemotherapy for haematological malignancy is presented. Based on similar cases in the literature, the patient was treated with lamivudine and maintenance chemotherapy was continued. In the fourth week of treatment, transaminase levels were normal and anti-HBs was positive. In immunocompromised patients in whom AHB develops, many questions such as the effectiveness of lamivudine treatment, duration of treatment, whether or not to suspend the chemotherapy and when to continue the chemotherapy are still unanswered. Lamivudine experience in this case is reported because there is no guide for this subject in the literature except few case reports.