Supplemental Material for: Hepatitis B Virus Reactivation During FOLFIRINOX Chemotherapy and Granulocyte Colony-Stimulating Factor in Advanced Pancreatic Cancer Case Report

FOLFIRINOX was held during admission because of poor tolerance. Liver enzymes rose during hospitalization, and hepatitis testing demonstrated reactive HBsAg and total anti-HBc, nonreactive anti-HBc IgM, anti-HBs <5 mIU/mL, and HBV DNA 3,760,000 IU/mL (log 6.58). Review of prior records demonstrated HBsAg positivity and negative anti-HBc IgM before chemotherapy, but baseline HBV DNA was not obtained and antiviral prophylaxis was not documented.

He was discharged on June 7 and was subsequently started on entecavir 0.5 mg daily by outpatient oncology on June 18.</p><p dir="ltr">Conclusion: Current guidelines recommend HBV screening before systemic anticancer therapy and antiviral prophylaxis for HBsAg-positive patients receiving systemic therapy. Thus, this case highlights the importance of implementing existing recommendations for complete HBV screening, baseline HBV DNA assessment, and antiviral prophylaxis in patients with solid tumors receiving chemotherapy.</p>