Fulminant B hepatitis in a surface antigen and hepatitis B DNA-negative patient with diffuse large B-cell lymphoma after CHOP chemotherapy plus rituximab

Yamagata, Michiko; Murohisa, Toshimitsu; Tsuchida, Kenji; Okamoto, Yutaka; Tsunoda, Saburo; Nakamura, Masae; Kusano, Koji; Majima, Yuichi; Kuniyoshi, Toru; Iijima, Makoto; Sugaya, Hitoshi; Hiraishi, Hideyuki

doi:10.1080/10428190601059704

Cited by 31 publications

(21 citation statements)

References 8 publications

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“…The rate of HBV reactivation with rituximab therapy has not been defined but appears to be high. Thus, in the 12 individual case reports of HBV reactivation associated with rituximab therapy in the literature, the mortality rate was 83%, and five cases occurred in patients who were HBsAg‐negative before therapy (reverse seroconversion) 8, 18–28. In cases of reverse seroconversion, the reappearance of HBsAg and HBV DNA typically occurs late, after several cycles of chemotherapy with rituximab, and generally at a time when anti‐HBs and anti‐HBc have fallen to low or undetectable levels (Fig.…”

Section: The Frequency Of Hbv Reactivationmentioning

confidence: 99%

Reactivation of hepatitis B # †

2009

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Section: The Frequency Of Hbv Reactivationmentioning

confidence: 99%

Reactivation of hepatitis B # †

2009

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“…Furthermore, anti-HBc-positive patients who had HBsAg seroclearance and patients positive for both anti-HBc and anti-HBs who require such therapies should be considered as candidates for antiviral treatment [146,[149][150][151]. Patients who are HBV DNA-negative and anti-HBs-positive only may not require antiviral therapy.…”

Section: Hbv and Hiv Coinfectionmentioning

confidence: 97%

The Management of Chronic Hepatitis B in Asian Americans

et al. 2011

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Hepatitis B virus (HBV) infection is common with major clinical consequences worldwide. In Asian Americans, the HBsAg carrier rate ranges from 7 to 16%; HBV is the most important cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Patients are first diagnosed at different stages of clinical disease, which is categorized by biochemical and virologic tests. Patients at risk for liver complications should be identified and offered antiviral therapy. The two antiviral agents recommended for first-line treatment of chronic hepatitis B (CHB) are entecavir and tenofovir. The primary goal of therapy is sustained suppression of viral replication to achieve clinical remission, reverse fibrosis, and prevent and reduce progression to end-stage liver disease and HCC. Asian patients with chronic hepatitis, either HBeAg-positive or -negative, with HBV DNA levels >10(4) copies/mL (>2,000 IU/mL) and alanine aminotransferase (ALT) values above normal are candidates for antiviral therapy. HBeAg-negative patients with HBV DNA >10(4) copies/mL (>2,000 IU/mL) and normal ALT levels but who have either serum albumin ≤3.5 g/dL or platelet count ≤130,000 mm(3), basal core promoter mutations, or who have first-degree relatives with HCC should be offered treatment. Patients with cirrhosis and detectable HBV DNA must receive antiviral therapy. Considerations for treatment include pregnant women with high viremia, coinfected patients, and those requiring immunosuppressive therapy. In HBsAg-positive patients with risk factors, lifelong surveillance for HCC with alpha-fetoprotein testing and abdominal ultrasound examination at 6-month intervals is required. These recommendations are based on a review of relevant literature and the opinion of a panel of Asian American physicians with expertise in hepatitis B treatment.

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“…HBsAg turning from negative to positive without evidence of new infection is defined as "HBsAg seroreversion" and this phenomenon is uncommon in cancer patients receiving conventional cytotoxic chemotherapy. Because rituximab has been routinely used for B-cell malignancies, this traditionally uncommon complication was observed at an increasing rate [65][66][67][68][69][70][71][72][73][74][75][76][77][78][79] . Yeo et al [34] performed the first retrospective study that showed the effect of rituximab on reactivation of HBV in patients with resolved HBV infection [34].…”

Section: Hbv Reactivation In Patients Receiving Rituximabmentioning

confidence: 99%

Risk and prophylaxis strategy of hepatitis B virus reactivation in patients with lymphoma undergoing chemotherapy with or without rituximab

Pei

Chen

2015

Leukemia & Lymphoma

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Hepatitis B virus (HBV) reactivation is a serious but preventable complication for patients with lymphoma receiving systemic therapy. Without antiviral prophylaxis, the HBV reactivation rate is estimated to be > 50% in patients who are positive for hepatitis B surface antigen (HBsAg), and fatal hepatic failure is not uncommon. Current guidelines suggest that routine antiviral prophylaxis should be administered to all HBsAg-positive patients until 6-12 months after completion of chemotherapy. For those who are negative for HBsAg and positive for hepatitis B core antibody, HBV reactivation is uncommon when a conventional dose of chemotherapy is administered. However, with rituximab-containing immunochemotherapy, the HBV reactivation rate is 18% and the clinical course can vary from asymptomatic viremia to fulminant hepatic failure that can be potentially fatal. In this review, we discuss the risk, clinical course and prophylactic strategy of HBV reactivation in patients with lymphoma treated with chemotherapy with or without rituximab.

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Fulminant B hepatitis in a surface antigen and hepatitis B DNA-negative patient with diffuse large B-cell lymphoma after CHOP chemotherapy plus rituximab

Cited by 31 publications

References 8 publications

Reactivation of hepatitis B # †

Reactivation of hepatitis B # †

The Management of Chronic Hepatitis B in Asian Americans

Risk and prophylaxis strategy of hepatitis B virus reactivation in patients with lymphoma undergoing chemotherapy with or without rituximab

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