Hepatitis B virus reactivation in a patient with chronic GVHD after allogeneic peripheral blood stem cell transplantation.
We report a patient with fatal hepatitis B virus (HBV) reactivation after treatment for chronic graft-versus-host disease (GVHD) following allogeneic peripheral blood stem cell transplantation to treat chronic myelogenous leukemia. The presence of antibodies to hepatitis B surface antigen (HBsAb) prior to transplantation indicated previous HBV infection. Liver damage first developed 8 months after transplantation with the disappearance of HBsAb. Hepatitis B antigen was first noted during an examination of liver damage that occurred 22 months after transplantation. Retrospective examination of serum by real-time detection polymerase chain reaction (RTD-PCR) revealed HBV in both the first and second episodes of liver damage (89 copies/mL and 2 x 10(6) copies/mL, respectively). HBV may have been reactivated, leading to fatal liver damage in this HBsAb-positive patient. We propose that RTD-PCR-based analysis should be performed to diagnose liver dysfunction after hematopoietic stem cell transplantation.
Sakamaki
H
H
Hematopoietic Stem Cell Transplantation Team, Tokyo Metropolitan Komagome Hospital, Japan.
Sato
Y
Y
Mori
S I
SI
Ohashi
K
K
Tanikawa
S
S
Akiyama
H
H
Sasaki
T
T
Hiruma
K
K
D000914:Antibodies, Viral / Q000097:blood; D001773:Blood Cells / Q000166:cytology / Q000637:transplantation; D002908:Chronic Disease; D017809:Fatal Outcome; D006086:Graft vs Host Disease / Q000150:complications* / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006509:Hepatitis B / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D006515:Hepatitis B virus / Q000254:growth & development* / Q000276:immunology; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000628:therapy; D017093:Liver Failure / Q000209:etiology / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood; D014184:Transplantation, Homologous / Q000009:adverse effects; D014775:Virus Activation
D000914:Antibodies, Viral; D012367:RNA, Viral