title: Fatal hepatitis B reactivation treated with entecavir in an isolated anti-HBs positive lymphoma patient: a case report and literature review.
abstract: Hepatitis B virus (HBV) reactivation is a well-recognized complication that occurs in lymphoma patients who undergo chemotherapy. Only very few cases of HBV reactivation in patients with isolated antibody against hepatitis B surface antigen (anti-HBs) have been reported. We present a case of a 78-year-old woman diagnosed with diffuse large B cell non-Hodgkin's lymphoma who only displayed a positive anti-HBs, as the single possible marker of occult HBV infection, before starting therapy. She was treated with several chemotherapeutic regimens (including rituximab) for disease relapses during 3 years. Forty days after the last cycle of chemotherapy, she presented with jaundice, markedly elevated serum aminotransferase levels, and coagulopathy. HBV serology showed positivity for HBsAg, anti-HBc and anti-HBs. HBV DNA was positive. Antiviral treatment with entecavir was promptly initiated, but the patient died from liver failure. A review of the literature of HBV reactivation in patients with detectable anti-HBs levels is discussed.
authors: Department of Gastroenterology, Hospital Center of Coimbra, Coimbra, Portugal. rosa.l.ferreira@gmail.com
authors: Rosa
authors: R
authors: Ferreira
authors: Joana
authors: J
authors: Carvalheiro
authors: Joana
authors: J
authors: Torres
authors: Alexandra
authors: A
authors: Fernandes
authors: Sílvia
authors: S
authors: Giestas
authors: Sofia
authors: S
authors: Mendes
authors: Cláudia
authors: C
authors: Agostinho
authors: Mário J
authors: MJ
authors: Campos
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D017809:Fatal Outcome; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006509:Hepatitis B / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D000069283:Rituximab; D014775:Virus Activation
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D000069283:Rituximab; C413685:entecavir; D006147:Guanine