Late hepatitis B virus reactivation after lamivudine prophylaxis interruption in an anti-HBs-positive and anti-HBc-negative patient treated with rituximab-containing therapy
Late hepatitis B virus reactivation after lamivudine prophylaxis interruption in an anti-HBs-positive and anti-HBc-negative patient treated with rituximab-containing therapy
复制标题
DOI：
10.1016/j.jinf.2011.11.021
复制
发表时间：
2012-08-01
影响因子：
28.2
通讯作者：
Sarrecchia, Cesare
中科院分区：
文献类型：
--
作者：
Ceccarelli, Laura;Salpini, Romina;Sarrecchia, Cesare
我们描述了一例抗-HBs阳性患者，在停用利妥昔单抗18个月后和拉米夫定预防性治疗12个月后出现B型肝炎复发。该患者携带携带一种携带单一免疫逃逸突变sT 118 K的D基因型B型肝炎病毒。没有共识的指导方针，关于最佳的治疗时间或最佳的选择性药物已被定义为抗病毒预防乙肝病毒抗原阴性，抗-HBc和/或抗-HBs阳性患者接受免疫抑制剂treatment.Screening的基础上HBV血清学标志物和HBV DNA检测是一个关键问题，以尽早认识到B肝炎再激活。此外，鉴定替代标志物（例如cccDNA、HBV核心相关抗原等）非常重要，这可能预示着HBV的再激活。(C)2011年，英国传染病协会。由爱思唯尔有限公司出版。保留所有权利。
We describe a case of an anti-HBs-positive patient who experienced hepatitis B reactivation 18 months after the discontinuation of rituximab and after 12 months of lamivudine prophylaxis. The patient carried a hepatitis B genotype D virus harbouring a single immune escape mutation, sT118K. No consensus guidelines regarding the optimal length of treatment or the best elective drug have been defined for antiviral prophylaxis for HBsAg-negative, anti-HBc- and/or anti-HBs-positive patients undergoing immunosuppressive treatment.Screening based on HBV serological markers and HBV DNA testing is a critical issue to recognise hepatitis B reactivation as early as possible. Furthermore, it is of outstanding importance to identify alternative markers (e.g. cccDNA, HBV core related antigen, etc.), that could be predictive of HBV reactivation. (C) 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.