Hepatitis B reactivation despite entecavir prophylaxis in a patient with chronic lymphocytic leukaemia receiving bendamustine.

The qPCR and RFLP analyses disagreed in two cases (7.7%), where the rs8099917 genotype was determined by RFLP to be TT and qPCR indicated that it was TG. We arbitrarily considered the qPCR results to be the gold standard for analysis. The prevalence of IL28B CC (rs12979860) in European patients was 46% 7 and for TT (rs8099917) the prevalence was 51.5%, 9 whereas in the present study, the frequencies were 34.6% and 53.8%, respectively. Moreover, there was no statistical correlation between the TT IL28B (rs8099917) genotype and SVR, possibly due to the modest influence of this SNP and/ or the small sample size. To our knowledge, this is the first study evaluating the prevalence of IL28B SNPs in a Latin-American population. The analysis presented here was limited due to the low statistical power associated with the small sample size. Nevertheless, we observed a significant association between the IL28B CC genotype and SVR in Brazilian patients coinfected with HIV, as has been shown in case studies in Western Europe. References 1 Muir AJ, Bornstein JD, Killenberg PG et al. Peginterferon alfa-2b and ribavirin for the treatment of chronic hepatitis C in blacks and non-Hispanic whites. 3 Liu CH, Liu CJ, Lin CL et al. Pegylated interferon-a-2a plus ribavirin for treatment-naive Asian patients with hepatitis C virus genotype 1 infection: a multicenter, randomized controlled trial. et al. Genome-wide association of IL28B with response to pegylated interferon-a and ribavirin therapy for chronic hepatitis C. 7 Ralló n NI, Naggie S, Benito JM et al. Association of a single nucleotide polymorphism near the interleukin-28B gene with response to hepatitis C therapy in HIV/hepatitis C virus-coinfected patients. et al. IL28B SNP rs8099917 is strongly associated with pegylated interferon-a and ribavirin therapy treatment failure in HCV/HIV-1 coinfected patients. Sir, Several lines of evidence have shown that the occurrence of hepatitis B virus (HBV) reactivation is greatly reduced by the identification of high-risk patients and the use of prophylactic antiviral therapy. 1 Although the occurrence of HBV reactivation depends on HBV-DNA levels, the risk is also strongly linked to immunosuppressive drugs used as part of chemotherapeutic regimens. Bendamustine is a well-known chemotherapeutic agent with both alkylating and purine-like properties that has been recently used for the treatment of chronic lymphocytic leukaemia (CLL). Herein we report the case of a CLL patient with HBV infection [hepatitis B surface antigen (HBsAg) positive/HBV-DNA negative] who developed HBV reactivation during bendamustine …