Reactivation of hepatitis B two years after rituximab therapy in a renal transplant patient with recurrent focal segmental glomerulosclerosis: a note of caution.
We report on the reactivation of hepatitis B in a renal transplant patient who had been treated with rituximab for recurrent focal segmental glomerulosclerosis two and a half yr previously. He lost his anti-hepatitis B surface antigens and anti-hepatitis B core antigen antibodies and developed hepatitis B virus (HBV)-DNA positive hepatitis. Hepatitis C, which had been successfully treated by alpha interferon 10 yr before, remained quiescent. We suggest regular controls of HBV-DNA, anti-HBV antibodies and transaminases for prolonged periods in patients with status post-hepatitis B treated with rituximab. Prophylactic therapy with lamivudine and/or hepatitis B hyperimmune globulin may be considered in patients with a decrease in anti-HBV antibodies.
Gossmann
Jan
J
Transplantationsambulanz, KfH Nierenzentrum, Klinikum der J.W. Goethe-Universitaet, Frankfurt, Germany. j.gossmann@em.uni-frankfurt.de
Scheuermann
Ernst-Heinrich
EH
Kachel
Heinz-Georg
HG
Geiger
Helmut
H
Hauser
Ingeborg A
IA
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy*; D006509:Hepatitis B; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D012008:Recurrence; D012086:Reoperation; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab