Hepatitis B virus (HBV) reactivation is a known complication of immunosuppressive therapy. While patients who are undergoing treatment with anti-CD20 agents or stem cell transplantation are commonly screened for chronic HBV infection prior to treatment, there are no consensus guidelines regarding HBV screening for patients undergoing chemotherapy for solid tumors. We present a rare case of fulminant liver failure due to HBV reactivation in a patient receiving chemotherapy for breast cancer. Our case highlights the importance of developing definitive guidelines regarding HBV screening in patients receiving chemotherapy for solid tumors and raises the question of the need for universal screening.
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