Reactivation of hepatitis B virus following rituximab-based regimens: a serious complication in both HBsAg-positive and HBsAg-negative patients
Reactivation of hepatitis B virus following rituximab-based regimens: a serious complication in both HBsAg-positive and HBsAg-negative patients
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DOI：
10.1007/s00277-009-0806-7
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发表时间：
2010-03-01
影响因子：
3.5
通讯作者：
Kuo, Ching-Yuan
中科院分区：
文献类型：
--
作者：
Pei, Sung-Nan;Chen, Chien-Hung;Kuo, Ching-Yuan
B型肝炎病毒（HBV）再激活是前利妥昔单抗时代淋巴瘤治疗的一个众所周知的并发症。然而，自从单克隆抗CD20抗体成为B细胞淋巴瘤的标准治疗方案以来，这种并发症还没有得到很好的研究。在这项回顾性研究中，分析了115例接受含利妥昔单抗治疗的B细胞淋巴瘤患者。在15例B型肝炎表面抗原（HBsAg）阳性患者中，5例接受拉米夫定预防治疗，在淋巴瘤治疗期间未发生HBV相关性肝炎。10例未接受拉米夫定预防治疗的HBV携带者中有8例发生HBV相关肝炎，包括1例致命性肝功能衰竭。95例HBsAg阴性患者中有4例（4.2%）发生了新发HBV相关肝炎，2例死于暴发性肝炎。总之，利妥昔单抗为基础的治疗可能会导致严重的HBV相关的并发症，甚至死亡的HBsAg阳性和HBsAg阴性的患者。
Hepatitis B virus (HBV) reactivation is a well-known complication of lymphoma treatment in the pre-rituximab era. This complication has not been as well studied, however, since monoclonal anti-CD20 antibody became the standard regimen for B cell lymphoma. In this retrospective study, 115 B cell lymphoma patients who received rituximab-containing therapy were analyzed. Of 15 hepatitis B surface antigen (HBsAg)-positive patients, five received lamivudine prophylaxis and did not develop HBV-related hepatitis during lymphoma treatment. Eight of ten HBV carriers without lamivudine prophylaxis experienced HBV-related hepatitis, including one fatal hepatic failure. Four (4.2%) of 95 HBsAg-negative patients developed de novo HBV-related hepatitis and two died of fulminant hepatitis. In conclusion, rituximab-based therapy may cause serious HBV-related complications and even death in both HBsAg-positive and HBsAg-negative patients.