Chronic Myeloid Leukemia in a Patient with Hepatitis B Virus Infection: A Case Report

Abstract

Chronic myeloid leukemia (CML) is a myeloproliferative disorder diagnosed by demonstrating the Philadelphia chromosome (Ph) or the BCR-ABL fusion gene. Tyrosine kinase inhibitors (TKIs) are the standard of therapy. There are increasing reports of hepatitis B virus reactivation (HBVr) in patients on this treatment. We report a case of a 46-year-old male patient diagnosed to have CML in the chronic phase and resolved hepatitis B infection. He was treated with imatinib as upfront therapy for CML and with lamivudine as prophylaxis against HBVr. The patient tolerated both treatments well with no adverse effects. The aim is to address the deficiencies in the literature in regard to managing these patients, prevention, and follow-up.

Detection of Hepatitis B Virus (HBV) Genotypes by Nested Polymerase Chain Reaction (PCR) Technique in Diyala Province

“…The Nested PCR products after amplification using specific primers have been presented to the gel electrophoresis, which showed the bands, as shown in the figures ( 1) and ( 2). The current study demonstrated that each genotype contributes a certain amount to the genotype mixture where the ratio was as follows: genotype D (93%), B (79%), C (64%), A (57%), E (21%), and F (0%), as shown in figure (3). HBV genotyping method developed based on PCR amplification assay utilizing type specific primers capable of recognizing six primary HBV genotypes (A-F) [10].…”

“…This could be attributable to viral serum load, the sensitivity and specificity of the ELISA test used, sample size, or geographical location. The results of liver function tests revealed that the levels of ALT, AST, and ALP in patients were high (36.31±12.00, 47.92±21.00, and 100.24±45.92) respectively, than controls as shown in table (3). The sensitivity of ALP(83%) and AST(60%) scored highest than ALT (42%) with significant difference.…”

“…It is one of the leading causes of acute or chronic HBV infection worldwide [2]. Although extensive vaccination programs and developments in the treatment of hepatitis B (HBV) in many countries have resulted in a reduction in the disease's spread, inadequate vaccination coverage and the disease's status as a major global health concern have resulted in a high HBV global burden [3]. Geographical variation in HBV genotype distribution may be an indication of how the virus spreads.…”