Resurrection of Hepatitis B

[Virosafe2001]

I have been diagnosed with CLL for 7 years (Now stage C) and was about to start Chemotherapy (BTK inhibitor). I had a short illness with Hepatitis B in 1975 (while working in a clinical virology lab in an HBV high-risk environment). This cleared within 2 weeks. 20 years later I received HBV vaccine. I have remained positive for anti-HBV(core) antibody, but have just recently tested positive for both HB Surface antigen and HBV DNA. As I have been shielding from Covid-19 for the past 2 years, and have had no transfusions or blood products, I am assuming this is a resurgence of my original infection, which can occur in CLL patients, but usually after chemotherapy has started. Has anyone out there had a similar experience? My starting chemotherapy has been put on hold for now.

[Vlaminck]

Hi, Virosafe-- so sorry to hear your HepB has resurrected! Are you just going to wait until you again mount defense to HepB, then proceed? I am in a similar potential situation: In 2019, I gave blood at a blood drive (months before CLL diagnosis), only to learn I showed that I had had Hep B at some point (had core antibody but no antigen). Then had DNA tests, and no virus in blood. What was shocking and freaked me out is that I never knowingly had it, and the only thing I can figure is that I got it when I had two shots of penicillan in the 70s in Guatemala City ( doc gave me vials and I had to go a pharmacy two diff times for administration, and they took me to a back room -- bet real sterile). Unsuspecting, I also since had two HepB vaccines. Since discovery (if I hadn't given blood, probably still wouldn't know), was told by liver specialist to let him know if ever on immune suppressive anything. Haven't been back in touch, but periodically ask my Oncologist (cll guy) to test for antigens. So far, so good. But it's another of those black clouds out there. Please keep us posted, as I hope your body kicks this back again!

[AnneHill]

My Mother is in a carehome and I went to see her in her room. I wore a mask and didnt touch her. I washed and sterilised my hands on leaving.I had been there a while and a carer told me she had stayed in bed the day before. She was cold and unwell. A lateral flow test was negative. The following day she was positive for covid. The pcr confirmed it.

I didnt catch it but was annoyed that they hadnt told me she was unwell. It was 2 days after she was unwell that a test was positive. It shows that the lateral flow didnt show until after she had symptoms.

[ttomo]

Reactivation of Hep B is a major concern with any of the drugs currently used to treat CLL. All I know is that a couple of months prior to the beginning of my treatment I had to begin prophylactic treatment to prevent a reactivation of Hep B (Tenofovir) That continued during the 14-month course of treatment (I+O+V) and for a year following treatment. I am unaware of the possibility of reactivation simply because of CLL. Wishing you well with everything.

[SofiaDeo in reply to ttomo]

CLL affects immunity, and as immunity fluctuates our risk of reactivation changes. Worldwide there have been major stressors due to Covid & decisions made around Covid. Weather disasters have affected many physically as well as emotionally. Recently there is the conflict between Ukraine and Russia adding to this. Let alone any other stressors various life events cause. While it's true treatment related immune suppression easily accounts for disease recurrence, IMO it's not the only one. I was enjoying an almost 5 year remission, and had an mmmmm 6 month period of severe emotional and physical stressors. I came out of remission a few months after that.

[lexie]

My husband had a liver transplant where he accepted a liver that tested positive for Hep B. His blood type was rare and this was his only chance at a match. Epivir kept Hep B under detectable levels for a year but suddenly increased for no apparent reason. His immune suppressant meds were at consistent doses, and he was compliant. He sat for an infusion of HBIG one time and no further issues. I know his experience was not CLL related as you asked but may be helpful.