Reactivation of infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) is defined as increased viral replication in patients with previously low-grade chronic infection. This may occur following the use of immunomodulatory therapy, chemotherapy or in response to severe illness. Most cases of HBV reactivation are asymptomatic; however, hepatic decompensation can occur in severe cases, where HBV reactivation is associated with a mortality of up to 30%.1 Over the last decade, it has been recognised that HBV reactivation can be effectively prevented by antiviral prophylaxis. In contrast, severe flares of hepatitis in response to HCV reactivation are less commonly reported and, when they occur, are associated with a much lower mortality. This article summarises the recent advances in this area and provides guidance for the management of HBV and HCV reactivation in patients undergoing chemotherapy.
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