Elevation of the Hepatitis B Virus DNA during the Treatment of Polycythemia Vera with the JAK Kinase Inhibitor Ruxolitinib
Elevation of the Hepatitis B Virus DNA during the Treatment of Polycythemia Vera with the JAK Kinase Inhibitor Ruxolitinib
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DOI：
10.2169/internalmedicine.55.5529
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发表时间：
2016-01-01
影响因子：
1.2
通讯作者：
Enomoto, Nobuyuki
中科院分区：
文献类型：
--
作者：
Kirito, Keita;Sakamoto, Minoru;Enomoto, Nobuyuki
Ruxolitinib是骨髓纤维化的一种有用的治疗选择，因为它有效地解决了脾肿大和全身症状。ruxolitinib在临床试验之外广泛使用后，一系列病例报告表明存在ruxolitinib相关机会性感染的潜在风险，包括B型肝炎病毒（HBV）的再活化。我们在此报告一例真性红细胞增多症患者，在开始使用鲁索利替尼后，HBV-DNA病毒DNA升高，天冬氨酸氨基转移酶（AST）和丙氨酸氨基转移酶（ALT）升高。立即开始恩替卡韦抗病毒治疗，此后HBV病毒载量随着肝功能的改善而下降。因此，医生应了解ruxolitinib相关HBV再激活的潜在风险。
Ruxolitinib is a useful treatment option for myelofibrosis since it effectively resolves splenomegaly and constitutional symptoms. After the widespread use of ruxolitinib outside of clinical trials, a series of case reports indicated a potential risk of ruxolitinib-associated opportunistic infections, including the reactivation of the hepatitis B virus (HBV). We herein report the case of a polycythemia vera patient who showed an elevation of HBV-DNA viral DNA with an elevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) after the initiation of ruxolitinib. Anti-viral therapy with entecavir was immediately started and the HBV viral load thereafter decreased with an improvement of the liver function. Physicians should thus be aware of the potential risk of ruxolitinib-associated HBV reactivation.