Hepatitis B virus reactivation in a surface antigen-negative and antibody-positive patient after rituximab plus CHOP chemotherapy.
Hepatitis B virus reactivation in a surface antigen-negative and antibody-positive patient after rituximab plus CHOP chemotherapy.
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DOI：
10.4143/crt.2008.40.1.36
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发表时间：
2008-03-01
影响因子：
4.6
通讯作者：
Kim, Seok Jin
中科院分区：
文献类型：
--
作者：
Kim, Eui Bae;Kim, Dae Sik;Kim, Seok Jin
利妥昔单抗是一种针对 B 淋巴细胞的单克隆抗体，广泛用于治疗非霍奇金淋巴瘤。然而，它的使用与 HBV 再激活有关，而这与利妥昔单抗的免疫抑制作用有关。尽管大多数再激活发生在乙型肝炎携带者中，但也有少数再激活病例发生在 HBsAg 阴性患者中。然而，韩国从未报道过 HBsAg 阴性/HBsAb 阳性患者在利妥昔单抗治疗后重新激活的情况。我们在此介绍一名 HBsAg 阴性/HBsAb 阳性 66 岁女性，她在接受利妥昔单抗加 CHOP 化疗治疗弥漫性大 B 细胞淋巴瘤后出现再激活。虽然她在诊断时 HBsAg 呈阴性，但在复发时她的病毒状态发生了如下变化：HBsAg 阳性、HBsAb 阴性、HBeAg 阳性、HBeAb 阴性以及 HBV DNA 水平为 1165 pg/ml。我们的观察表明，当怀疑既往有 HBV 感染或隐匿性感染时，甚至在 HBsAg 阴性/HBsAb 阳性病例中，我们应该在利妥昔单抗治疗期间监测 HBV 再激活。
Rituximab is a monoclonal antibody that targets B-lymphocytes, and it is widely used to treat non-Hodgkin's lymphoma. However, its use has been implicated in HBV reactivation that's related with the immunosuppressive effects of rituximab. Although the majority of reactivations occur in hepatitis B carriers, a few cases of reactivation have been reported in HBsAg negative patients. However, reactivation in an HBsAg negative/HBsAb positive patient after rituximab treatment has never been reported in Korea. We present here an HBsAg-negative/HBsAb-positive 66-year-old female who displayed reactivation following rituximab plus CHOP chemotherapy for diffuse large B-cell lymphoma. While she was negative for HBsAg at diagnosis, her viral status was changed at the time of relapse as follows: HBsAg positive, HBsAb negative, HBeAg positive, HBeAb negative and an HBV DNA level of 1165 pg/ml. Our observation suggests that we should monitor for HBV reactivation during rituximab treatment when prior HBV infection or occult infection is suspected, and even in the HBsAg negative/HBsAb positive cases.