Illustration of liver protected from virus by shield.

HBV Reactivation: How to Protect Yourself During Cancer Treatment

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"A simple guide to understanding hepatitis B virus (HBV) reactivation and the best ways to prevent it when undergoing treatment for lymphoma."

Cancer treatment often involves powerful therapies like chemotherapy, which can weaken your immune system. This can create an opportunity for dormant viruses, like hepatitis B virus (HBV), to reactivate. If you’re a carrier of HBV, even if it’s inactive, certain cancer treatments can cause the virus to become active again, leading to liver damage and potentially disrupting your cancer therapy.

This article breaks down a study published in 'Blood First Edition Paper' that investigates the effectiveness of antiviral medications in preventing HBV reactivation in patients undergoing treatment for advanced-stage diffuse large B-cell lymphoma (DLBCL). DLBCL is a type of non-Hodgkin's lymphoma, a cancer that affects the lymphatic system. Understanding the risks and available preventive measures can help you navigate your cancer treatment with greater confidence.

The study focuses on comparing two antiviral drugs, tenofovir and lamivudine, in preventing HBV reactivation. By understanding the results of this research, you can have informed discussions with your healthcare team about the best strategies to protect your liver health during cancer treatment.

Understanding HBV Reactivation and Cancer Treatment

Illustration of liver protected from virus by shield.

HBV reactivation occurs when the virus, which has been lying dormant in your liver, starts to multiply again. This can happen when your immune system is weakened, such as during chemotherapy. The risk of HBV reactivation is particularly high in patients undergoing treatment for blood cancers like lymphoma, as the therapies used can severely suppress the immune system.

The original study highlights that anti-CD20 monoclonal antibodies (like rituximab), often used in lymphoma treatment, increase the risk of HBV reactivation. This underscores the importance of taking preventive measures if you are a HBV carrier and require such treatments.

Risk Factors: Certain cancer treatments, particularly those involving rituximab and chemotherapy, increase the risk of HBV reactivation.
Why it Matters: HBV reactivation can lead to liver damage, potentially disrupting or delaying cancer treatment.
Preventive Measures: Antiviral medications can effectively prevent HBV reactivation and protect your liver health.

The study published in 'Blood First Edition Paper' specifically looked at patients with advanced-stage DLBCL, a type of aggressive lymphoma. These patients often require intensive chemotherapy regimens, making them particularly vulnerable to HBV reactivation. The research aimed to determine whether tenofovir or lamivudine was more effective in preventing this complication.

Take Control of Your Health During Cancer Treatment

If you are undergoing cancer treatment and are a carrier of HBV, it’s crucial to discuss preventive strategies with your healthcare team. The study we've discussed shows that antiviral prophylaxis, particularly with medications like tenofovir, can significantly reduce the risk of HBV reactivation. By staying informed and proactive, you can protect your liver health and ensure the best possible outcome from your cancer treatment. Always consult your doctor for personalized medical advice.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What is HBV reactivation and why is it a concern during cancer treatment?

HBV reactivation is when the hepatitis B virus, which may be dormant in your liver, becomes active again. This often occurs when the immune system is weakened, such as during cancer treatments like chemotherapy. The primary concern is that HBV reactivation can lead to liver damage and potentially disrupt or delay the ongoing cancer treatment, impacting overall health outcomes. Specifically, treatments for blood cancers like lymphoma, including therapies like rituximab, increase the risk, making preventive measures crucial for those who are HBV carriers.

What role do antiviral medications play in managing HBV reactivation for lymphoma patients?

Antiviral medications are a key preventive measure against HBV reactivation in lymphoma patients. The research, as referenced in the 'Blood First Edition Paper', investigated the efficacy of antiviral prophylaxis using drugs such as tenofovir and lamivudine. These medications work to prevent the hepatitis B virus from multiplying and reactivating, thereby protecting the liver and reducing the risk of complications. The use of antiviral medications allows patients to continue cancer treatment with reduced risk of liver damage.

Which cancer treatments are particularly associated with a higher risk of HBV reactivation?

Certain cancer treatments carry a higher risk of HBV reactivation, particularly those that severely suppress the immune system. Chemotherapy is a major factor, as it weakens the body's defenses. Additionally, treatments like rituximab, a type of anti-CD20 monoclonal antibody often used in lymphoma treatment, significantly increase the risk. Patients undergoing treatment for advanced-stage diffuse large B-cell lymphoma (DLBCL), who frequently receive intensive chemotherapy regimens, are especially vulnerable, highlighting the need for preventative strategies.

How does DLBCL treatment relate to the risk of HBV reactivation, and what preventative steps can be taken?

Patients with advanced-stage diffuse large B-cell lymphoma (DLBCL) often require aggressive chemotherapy regimens, which significantly increase the risk of HBV reactivation. This is due to the immune-suppressing effects of these treatments. Preventative steps include the use of antiviral medications like tenofovir or lamivudine. These medications can effectively prevent the virus from reactivating, thereby protecting liver health and allowing patients to continue their cancer treatment with reduced risk.

Why is it important for HBV carriers undergoing cancer treatment to discuss preventive strategies with their healthcare team?

It is crucial for HBV carriers undergoing cancer treatment to discuss preventive strategies with their healthcare team because treatments like chemotherapy and rituximab can increase the risk of HBV reactivation. Reactivation can lead to liver damage and may disrupt or delay cancer treatment. By discussing preventive measures, patients can ensure their liver health is protected. Proactive discussions allow healthcare providers to prescribe antiviral prophylaxis, such as tenofovir, to minimize the risk, improve the outcomes, and ensure the cancer treatment proceeds as planned.