Older Age and a Weakened Immune System Can Cause HBV to Reactivate


— Christine M. Kukka, Project Manager, HBV Advocate

Doctors know that an immune system weakened by chemotherapy can cause even a resolved or dormant hepatitis B infection to reactivate, but new information shows old age, other diseases, or surgery can also cause HBV to rebound.

According to a study published in the January 2015 issue of the Journal of Medical Virology, two elderly men had spontaneous reactivation of hepatitis B following surgery and development of diabetes.

Both had resolved hepatitis B infections and one even had hepatitis B surface antibodies, indicating he had cleared the infection.

In one case, a 73-year-old male had surgery in 2008 and at the time tested positive for surface antibodies, which should indicate he had cleared the infection. However, in 2009 he redeveloped HBsAg, HBeAg and a high level of HBV DNA, along with elevated ALT levels due to a weakened immune system.

In the other case, reported in the journal, a 76-year-old male who had been operated on for esophageal cancer in 2002, was diagnosed with diabetes in 2009. At that time he tested negative for HBsAg.

However, he tested positive for HBsAg in September 2012 just before he underwent another round of surgery for recurrent esophageal cancer. In the ensuing months, his viral load increased greatly as the infection reactivated as a result of his weakened immune system.

"Aging, surgical stress and complication of diseases associated with compromised immunity, such as cancer, arteriosclerosis and diabetes may trigger spontaneous HBV reactivation," the researchers reported.

Source: www.ncbi.nlm.nih.gov/pubmed/25612181

http://www.hbvadvocate.org/news/HBJ12.2.htm

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