[Fulminant Hepatic Failure With Hepatitis B Virus Reactivation After Rituximab Treatment in a Patient With Resolved Hepatitis B]

Korean J Gastroenterol. 2010 Apr;55(4):266-9. doi: 10.4166/kjg.2010.55.4.266.
[Article in 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-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.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents / therapeutic use*
  • Antiviral Agents / therapeutic use
  • DNA, Viral / analysis
  • Female
  • Guanine / analogs & derivatives
  • Guanine / therapeutic use
  • Hepatitis B / diagnosis*
  • Hepatitis B / drug therapy
  • Hepatitis B virus / isolation & purification
  • Humans
  • Liver Failure, Acute / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Recurrence
  • Rituximab

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Antiviral Agents
  • DNA, Viral
  • Rituximab
  • entecavir
  • Guanine