Anti-HBs-Positive Liver Failure Due to Hepatitis B Virus Reactivation Induced by Rituximab

Sera, Toshiki; Hiasa, Yoichi; Michitaka, Kojiro; Konishi, Ichiro; Matsuura, Kazuaki; Terada, Yoshio; Matsuura, Bunzo; Kajiwara, Takeshi; Masumoto, T.; Horiike, Norio; Onji, Morikazu

doi:10.2169/internalmedicine.45.1590

Cited by 119 publications

(70 citation statements)

References 18 publications

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“…Various studies have shown that patients with chronic HBV infection are at risk of HBV reactivation during chemotherapy 7,11,[21][22][23][24][25] and recently, the use of rituximab has also been demonstrated to increase the rates of viral infection and viral reactivation. [11][12][13][14] In contrast, the risk of developing HBV-related liver complications after chemotherapy and immunotherapy in patients with past HBV (isolated HBcAb positive) infection has not been well studied. The results of the current study found the risk of HBV reactivation during the course of systemic chemotherapy to be low; only 1 (1.5%) of the 67 patients experienced reactivation.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, the association between rituximab and HBV reactivation is still unknown, although a study by Sera et al has shown that rituximab suppresses the B lymphocytes, impairing the number and function of B lymphocytes, and may result in HBV reactivation. 11 Rituximab appeared to reduce the antibody to hepatitis B surface antigen (HBsAb), and thus might induce an immunological environment that allows for easy HBV reactivation. 12 Several case reports suggest that rituximab in combination with chemotherapy may increase the risk of HBV reactivation.…”

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confidence: 99%

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Hepatitis B virus reactivation and role of antiviral prophylaxis in lymphoma patients with past hepatitis B virus infection who are receiving chemoimmunotherapy

Koo

Tan

et al. 2009

Cancer

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BACKGROUND: Individuals who had past hepatitis B virus (HBV) infection appeared to clear their serum hepatitis B surface antigen (HBsAg) while producing antibody to the hepatitis B core antigen (HBcAb), which is detectable in their serum. Currently, it is uncertain whether patients with past HBV infection require routine antiviral prophylaxis during chemotherapy, although some cancer agencies recommend its routine use. The objective of the current study was to determine the prevalence of past HBV infection in patients with lymphoma and its relevance in terms of HBVrelated complications. METHODS: The authors reviewed 430 patients with lymphoma from May 2006 to May 2008. RESULTS: Among the 430 patients, 233 had both the HBsAg and HBcAb tests performed, whereas 197 had only the HBsAg test performed. Among those with both tests performed, 34.3% (80 of 233) were HBcAb positive only. Of these 80 patients, 58 had a concomitant HBV DNA level test, which was positive in 3 (5.2%). Of the 67 patients with past and 26 with chronic HBV infection who received chemotherapy, HBV reactivation occurred in 1.5% and 42.3% of patients, respectively (P<.0001). Prophylactic lamivudine was administered in 7 (10.4%) patients with past HBV infection and in 18 (69.2%) with chronic HBV infection. CONCLUSIONS: The low rate of HBV reactivation reported in our study coupled with the high prevalence of past HBV infection in an endemic area suggests that routine usage of antiviral prophylaxis may not be required for all patients with past HBV infection. Close surveillance remains a reasonable and viable option for the majority of patients. Cancer 2010;116:115-21.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Hepatitis B virus reactivation and role of antiviral prophylaxis in lymphoma patients with past hepatitis B virus infection who are receiving chemoimmunotherapy

Koo

Tan

et al. 2009

Cancer

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“…In the same cohort of patients the incidence of HBV reactivation rose significantly in the past decade, after the introduction of rituximab, a monoclonal antibody targeted against the CD20(+) lymphocytes (2,3). In this setting, reactivation was recorded even in HBsAb (+) patients (4). In patients with rheumatic diseases, analogous cases are still mainly anecdotal.…”

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confidence: 99%

Reactivation of chronic hepatitis B virus infection following rituximab administration for rheumatoid arthritis

et al. 2009

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“…The majority of the liver derangements induced by cryoablation and sorafenib were transient and improved after stopping sorafenib. Furthermore, there are recent reports regarding the reactivation of hepatitis B infection in chronic hepatitis B carriers who received targeted therapy alone for the treatment of underlying malignancy [24,25] . Thus, it is possible that the administration of sorafenib will likewise lead to the reactivation of the underlying hepatitis B infection and result in worsening liver function, because most patients with advanced HCC in Asia are chronic hepatitis B carriers.…”

Section: Discussionmentioning

confidence: 99%

Sorafenib combined with cryoablation to treat unresectable hepatocellular carcinoma

Yang

Guo

et al. 2011

Chin. J. Cancer Res.

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Objective: To evaluate the efficacy and tolerability of sorafenib combined with cryoablation in treating unresectable hepatocellular carcinoma (HCC).Methods: Patients with unresectable advanced HCC received cryoablation and sorafenib at a dose of 400 mg twice daily in 4-week cycles on the same day of the cryoablation. Tumor response, median overall survival and the median time to radiological progression were calculated and the toxicity was evaluated.Results: Seventy-eight patients with unresectable HCC were involved in this study. The median age was 52 years (range, 22-81 years). The Eastern Cooperative Oncology Group (ECOG) performance status scores were 0 (39.7%), 1 (55.1%), and 2 (5.1%). Nine (11.5%) patients were at Barcelona clinic liver cancer (BCLC) stage A, twenty-four (30.8%) patients were at stage B and 45 (57.7%) patients were at stage C. Five (6.4%) achieved partial responses, and 34 (43.6%) achieved stable disease. The median time to progression (TTP) for all enrolled patients was 6.6 months and the median overall survival (OS) was 12.2 months.Conclusion: Cryoablation combined with sorafenib demonstrates good efficacy and acceptable tolerability in treating unresectable advanced HCC patients.

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Anti-HBs-Positive Liver Failure Due to Hepatitis B Virus Reactivation Induced by Rituximab

Abstract: A 59-year-old man developed acute hepatitis with reactivated hepatitis B virus (HBV) following administration of rituximab

Cited by 119 publications

References 18 publications

Hepatitis B virus reactivation and role of antiviral prophylaxis in lymphoma patients with past hepatitis B virus infection who are receiving chemoimmunotherapy

Hepatitis B virus reactivation and role of antiviral prophylaxis in lymphoma patients with past hepatitis B virus infection who are receiving chemoimmunotherapy

Reactivation of chronic hepatitis B virus infection following rituximab administration for rheumatoid arthritis

Sorafenib combined with cryoablation to treat unresectable hepatocellular carcinoma

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