Anti-HBs-positive liver failure due to hepatitis B virus reactivation induced by rituximab.
A 59-year-old man developed acute hepatitis with reactivated hepatitis B virus (HBV) following administration of rituximab (anti-CD20 monoclonal antibody). The patient was diagnosed with malignant lymphoma in 1998, and virus marker testing indicated HBV surface antigen (HBsAg)-negative and anti-HBs antibody (anti-HBs)-positive results when chemotherapy including rituximab was started. Levels of aminotransferases were elevated, and HBsAg results turned positive. Despite therapy for late-onset hepatic failure, the patient died. Rituximab appears likely to have induced HBV reactivation in this case. Anti-viral agents should be administered for both HBsAg-positive and anti-HBs-positive patients who are scheduled to receive rituximab.
Sera
Toshiki
T
Ehime University Graduate School of Medicine, Department of Gastroenterology and Metabology, Shitsukawa, Toon.
Hiasa
Yoichi
Y
Michitaka
Kojiro
K
Konishi
Ichiro
I
Matsuura
Kana
K
Tokumoto
Yoshio
Y
Matsuura
Bunzo
B
Kajiwara
Takeshi
T
Masumoto
Toshikazu
T
Horiike
Norio
N
Onji
Morikazu
M
D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents / Q000627:therapeutic use; D006509:Hepatitis B / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects / Q000276:immunology / Q000502:physiology*; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D017093:Liver Failure / Q000097:blood / Q000276:immunology* / Q000517:prevention & control; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D000637:Transaminases / Q000097:blood
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D007155:Immunologic Factors; D000069283:Rituximab; D000637:Transaminases