title: [Fulminant hepatic failure with hepatitis B virus reactivation after rituximab treatment in a patient with resolved hepatitis B].
abstract: It is well known that the reactivation of hepatitis B virus (HBV) may occur as an acute hepatitis after chemotherapy or immunosuppressive therapy. Although most of these cases have been reported in HBsAg-positive patients, there have been a few reports of HBV reactivation in HBsAg-negative patients. There have been concerns for the need to screen the reactivation as well as anti-viral prophylaxis in HBsAg-negative patients with possible HBV occult infection who are planning to undergo chemotherapy or immunosuppressive therapy. Rituximab, an anti-CD20 monoclonal antibody, is effective in the treatment of non-Hodgkins lymphoma. However, rituximab can affect the immunity against HBV, consequently increasing viral replication. In fact, there have been reports of HBV reactivation after treatment with rituximab. Here, we report a case of HBV reactivation following rituximab plus systemic chemotherapy in diffuse large B cell lymphoma patient who was HBsAg negative, anti-HBs positive, and anti-HBc positive, ultimately leading to treatment-unresponsive fulminant hepatic failure.
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
authors.forename: Seong Min
authors.initials: SM
authors.lastname: Chung
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
authors.forename: Tae Yeob
authors.initials: TY
authors.lastname: Kim
authors.forename: Ki Deok
authors.initials: KD
authors.lastname: Yoo
authors.forename: Yong Woo
authors.initials: YW
authors.lastname: Ahn
authors.forename: Joong Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Yong Cheol
authors.initials: YC
authors.lastname: Jeon
authors.forename: Jung Hye
authors.initials: JH
authors.lastname: Choi
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006509:Hepatitis B / Q000175:diagnosis* / Q000188:drug therapy; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D012008:Recurrence; D000069283:Rituximab
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000998:Antiviral Agents; D004279:DNA, Viral; D000069283:Rituximab; C413685:entecavir; D006147:Guanine