[Fulminant hepatic failure with hepatitis B virus reactivation after rituximab treatment in a patient with resolved hepatitis B].
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.
Chung
Seong Min
SM
Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Sohn
Joo Hyun
JH
Kim
Tae Yeob
TY
Yoo
Ki Deok
KD
Ahn
Yong Woo
YW
Bae
Joong Ho
JH
Jeon
Yong Cheol
YC
Choi
Jung Hye
JH
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
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000998:Antiviral Agents; D004279:DNA, Viral; D000069283:Rituximab; C413685:entecavir; D006147:Guanine