REACTIVATION OF CHRONIC HEPATITIS B-VIRUS INFECTION BY CANCER-CHEMOTHERAPY
REACTIVATION OF CHRONIC HEPATITIS B-VIRUS INFECTION BY CANCER-CHEMOTHERAPY
复制标题
DOI：
10.7326/0003-4819-96-4-447
复制
发表时间：
1982-01-01
影响因子：
39.2
通讯作者：
COSTA, J
中科院分区：
文献类型：
--
作者：
HOOFNAGLE, JH;DUSHEIKO, GM;COSTA, J
发现两名转诊接受癌症化疗的患者为慢性无症状B型肝炎表面抗原（HBsAg）携带者。他们的血清转氨酶水平正常，但他们的血清HBsAg和B e抗原抗体阳性。两例患者均在3个月内发生急性黄疸型肝炎。开始循环化疗在这两种情况下，这种疾病似乎是由B型肝炎复发引起的;它伴随着HBsAg滴度的显着增加和血清中出现B型肝炎病毒DNA和DNA聚合酶。1例患者在第2个疗程化疗后发生第2次急性肝炎，但2例患者最终均痊愈，HBsAg血清阴性。因此，癌症化疗药物显然可以重新激活无症状HBsAg携带者的B型肝炎。这种重新激活很可能是由于乙型肝炎B病毒合成增加，然后在治疗停止时宿主对B型肝炎病毒感染的免疫反应反弹。这种现象可能对慢性B型肝炎病毒感染的治疗具有重要意义。
Two patients referred for cancer chemotherapy were found to be chronic, asymptomatic hepatitis B surface antigen (HBsAg) carriers. They had normal serum aminotransferase levels but their sera were positive for HBsAg and antibody to hepatitis B e antigen. Both patients developed acute, icteric hepatitis within 3 mo. of starting cycled chemotherapy. In both cases, the disease seemed to be caused by a recurrence of type B hepatitis; it was accompanied by a marked increase in HBsAg titer and the appearance of hepatitis B virus DNA and DNA polymerase in the serum. One patient had a 2nd episode of acute hepatitis after a 2nd course of chemotherapy, but both patients ultimately recovered and became seronegative for HBsAg. Thus, cancer chemotherapeutic agents apparently can reactivate type B hepatitis in asymptomatic HBsAg carriers. This reactivation is most likely due to an increase in hepatitis B virus synthesis followed by a rebound in host immune responses to hepatitis B virus infection when therapy is stopped. Such a phenomenon could have important implications for the therapy of chronic hepatitis B virus infection.