在接受ibrutinib治疗的血清阴性隐性乙型肝炎患者中,乙型肝炎病毒的重新激活
Lok-Ka Lam1, Thomas Sau Yan Chan1, Yu-Yan Hwang1
1Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hongkong.
Virology journal
|August 1, 2023
概括
在ibrutinib治疗期间,B型肝炎病毒 (HBV) 的重新激活可能发生,即使在血清阴性隐性HBV感染的患者中也是如此. 早期查和监测对于患者开始ibrutinib治疗至关重要,以预防严重的肝脏并发症.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 病毒学 病毒学
背景情况:
- 易布鲁替尼是一种布鲁顿的氨酸激酶 (BTK) 抑制剂,用于成熟的B细胞恶性瘤.
- 乙型肝炎病毒 (HBV) 再激活是免疫抑制疗法的已知风险.
- 关于易布鲁替尼诱导的HBV再激活的数据有限,特别是在血清阴性隐性HBV中.
研究的目的:
- 在接受ibrutinib的血清阴性隐性HBV患者中报告HBV再激活的第一个病例.
- 强调HBV查和监测在接受ibrutinib治疗的患者中的重要性.
主要方法:
- 一个82岁的妇女患有血清阴性隐性HBV的病例报告.
- 在ibrutinib治疗期间监测肝功能测试和HBV血清标志物.
- 量化HBV DNA和启动抗病毒治疗.
主要成果:
- 患者在ibrutinib治疗期间发生了HBV复激活与HBsAg血清转化和高HBVDNA水平.
- 抗病毒疗法导致病毒载荷抑制和改善肝功能.
- 这一案例证明了HBV在以前未被识别的隐性HBV感染中重新激活.
结论:
- 在特有种群中,在ibrutinib治疗前和治疗期间进行系统的HBV查和监测至关重要.
- 应考虑对患者进行抗病毒预防,特别是那些患有HBV暴露的风险因素的患者.
- 需要进一步的研究和国际共识,以指导接受ibrutinib的患者的HBV管理.
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