Histological improvement with lamivudine therapy for de novo hepatitis B occurring in an anti-HBs-positive child after bone marrow transplantation.
We describe a 14-year-old bone marrow transplant recipient who was anti-HBs-positive before the procedure and afterwards developed acute infection with hepatitis B virus (HBV). Liver biopsies taken while symptomatic showed portal fibrosis progressing to cirrhosis. The patient responded to lamivudine treatment with HBeAg seroconversion and significant regression of fibrosis. Although the source and timing of HBV exposure remain unclear, the potential for severe hepatitis B infection following bone marrow transplant warrants caution. This case demonstrates that a symptomatic HBV infection can occur in an immunocompromised patient who had originally been anti-HBs-positive.
D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000209:etiology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000628:therapy; D008103:Liver Cirrhosis / Q000209:etiology / Q000821:virology; D014775:Virus Activation
D000914:Antibodies, Viral; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine