Acute exacerbation of hepatitis due to reactivation of hepatitis B virus with mutations in the core region after chemotherapy for malignant lymphoma.
A 43-year-old Japanese man who was positive for hepatitis B surface (HBs) antigen and HB e antibody, underwent chemotherapy for non-Hodgkin's lymphoma. After the chemotherapy he suffered from acute exacerbation of hepatitis because of reactivation of HBV. Recovery was achieved with interferon-alpha, glucagon-insulin therapy, and plasma exchange. Mutations were detected in codons 97, 100, 129, and 131 of the core region of HBV. The peptide encoded from the core region including such mutations possibly had greater antigenicity to induce cytotoxic T cell activity in the host. Core region mutations may be a crucial cause of the acute exacerbation of hepatitis B seen after chemotherapy.
Sato
T
T
Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine, Japan.
Kato
J
J
Kawanishi
J
J
Kogawa
K
K
Ohya
M
M
Sakamaki
S
S
Niitsu
Y
Y
D000208:Acute Disease; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D017931:DNA Primers / Q000737:chemistry; D004279:DNA, Viral / Q000032:analysis; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D005961:Glucosinolates / Q000276:immunology; D006509:Hepatitis B / Q000209:etiology* / Q000473:pathology; D006510:Hepatitis B Antibodies / Q000032:analysis; D006512:Hepatitis B Core Antigens / Q000187:drug effects / Q000235:genetics*; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D009154:Mutation / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use; D014775:Virus Activation / Q000187:drug effects*
D017931:DNA Primers; D004279:DNA, Viral; D005961:Glucosinolates; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; C064699:2-hydroxybut-3-enylglucosinolate; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone