title: Late hepatitis B virus reactivation after lamivudine prophylaxis interruption in an anti-HBs-positive and anti-HBc-negative patient treated with rituximab-containing therapy.
abstract: We describe a case of an anti-HBs-positive patient who experienced hepatitis B reactivation 18 months after the discontinuation of rituximab and after 12 months of lamivudine prophylaxis. The patient carried a hepatitis B genotype D virus harbouring a single immune escape mutation, sT118K. No consensus guidelines regarding the optimal length of treatment or the best elective drug have been defined for antiviral prophylaxis for HBsAg-negative, anti-HBc- and/or anti-HBs-positive patients undergoing immunosuppressive treatment. Screening based on HBV serological markers and HBV DNA testing is a critical issue to recognise hepatitis B reactivation as early as possible. Furthermore, it is of outstanding importance to identify alternative markers (e.g. cccDNA, HBV core related antigen, etc.), that could be predictive of HBV reactivation.
authors.affiliation: Infectious Disease Unit, Tor Vergata University Hospital, Rome, Italy. ceccadoc@yahoo.it
authors.forename: Laura
authors.initials: L
authors.lastname: Ceccarelli
authors.forename: Romina
authors.initials: R
authors.lastname: Salpini
authors.forename: Loredana
authors.initials: L
authors.lastname: Sarmati
authors.forename: Valentina
authors.initials: V
authors.lastname: Svicher
authors.forename: Ada
authors.initials: A
authors.lastname: Bertoli
authors.forename: Pasquale
authors.initials: P
authors.lastname: Sordillo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ricciardi
authors.forename: Carlo Federico
authors.initials: CF
authors.lastname: Perno
authors.forename: Massimo
authors.initials: M
authors.lastname: Andreoni
authors.forename: Cesare
authors.initials: C
authors.lastname: Sarrecchia
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods; D004358:Drug Therapy / Q000379:methods; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D020125:Mutation, Missense; D000069283:Rituximab; D014775:Virus Activation; D028761:Withholding Treatment
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D019259:Lamivudine; D000069283:Rituximab