Reactivation of hepatitis B virus with rituximab

Expert Opin Drug Saf. 2005 May;4(3):599-608. doi: 10.1517/14740338.4.3.599.


Rituximab has become a useful drug for the treatment of non-Hodgkin's lymphoma (NHL) and such autoimmune diseases as idiopathic thrombocytopenic purpura and rheumatoid arthritis. When combined with cytotoxic agents, rituximab showed synergistic effects for the treatment of NHL. In such treatment, hepatitis B virus (HBV) reactivation is a crucial complication when patients are treated with immunosuppressive or chemotherapeutic agents. Despite its treatment efficacy, several studies have pointed out unusual viral infections after its administration that resulted in fatal hepatitis due to HBV reactivation. In the cases at the authors' institute, the authors analysed the kinetics of HBV antibodies, HBV-reactivation timing, and the prophylactic efficacy of lamivudine. The authors reviewed their cases and the previous literature to clarify the characteristics of HBV-reactivated patients who were administered rituximab.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Murine-Derived
  • Antibodies, Viral
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Autoimmune Diseases / drug therapy
  • Hepatitis B / pathology*
  • Hepatitis B virus / pathogenicity*
  • Humans
  • Kinetics
  • Lamivudine / therapeutic use
  • Lymphoma, Non-Hodgkin / drug therapy
  • Rituximab


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antibodies, Viral
  • Antineoplastic Agents
  • Antiviral Agents
  • Lamivudine
  • Rituximab