Fulminant Hepatic Failure with Hepatitis B Virus Reactivation after Rituximab Treatment in a Patient with Resolved Hepatitis B.
10.4166/kjg.2010.55.4.266
- Author:
Seong Min CHUNG
1
;
Joo Hyun SOHN
;
Tae Yeob KIM
;
Ki Deok YOO
;
Yong Woo AHN
;
Joong Ho BAE
;
Yong Cheol JEON
;
Jung Hye CHOI
Author Information
1. Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, Guri, Korea. sonjh@hanyang.ac.kr
- Publication Type:Case Report ; English Abstract
- Keywords:
Hepatitis B;
Reactivation;
HBsAg;
Rituximab;
Lymphoma
- MeSH:
Aged;
Antibodies, Monoclonal/*therapeutic use;
Antineoplastic Agents/*therapeutic use;
Antiviral Agents/therapeutic use;
DNA, Viral/analysis;
Female;
Guanine/analogs &derivatives/therapeutic use;
Hepatitis B/*diagnosis/drug therapy;
Hepatitis B virus/isolation &purification;
Humans;
Liver Failure, Acute/*diagnosis;
Lymphoma, Large B-Cell, Diffuse/*drug therapy;
Recurrence
- From:The Korean Journal of Gastroenterology
2010;55(4):266-269
- CountryRepublic of Korea
- Language:Korean
-
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-Hodgkin's 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.
