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在Rituximab基化疗完成后33个月,B型肝炎病毒的延迟重新激活

Banri Ogawa¹, Toshiro Kamoshida¹, Asaji Yamamoto¹

¹Department of Gastroenterology, Hitachi General Hospital, Japan.

Internal medicine (Tokyo, Japan)

|April 13, 2025

概括

在Rituximab化疗期间,B型肝炎病毒 (HBV) 再激活发生在一名患有隔离抗HBc抗体的老年患者身上. 重新激活导致肝功能衰竭,但Tenofovir 胺酸烟酸治疗是有效的.

科学领域:

肝病学肝病学是一种肝病学.
在瘤学瘤学.
免疫学免疫学免疫学

背景情况:

乙型肝炎病毒 (HBV) 再激活是免疫抑制患者的一个问题.
孤立的抗HBc抗体 (IAHBc) 血清阳性表明过去的HBV暴露和潜在的风险.
基于rituximab的化疗可以增加HBV重新激活的风险.

研究的目的:

在患有IAHBc.的患者中报告HBV再激活病例.
为了突出延迟的HBV在rituximab治疗后的重新激活.
为了记录HBV再激活的临床过程和管理.

主要方法:

一个70多岁的女性患有卵泡淋巴瘤的病例报告.
患者接受了基于rituximab的化疗.
监测HBV血清标记物和HBVDNA水平.
用特诺福维尔阿拉芬胺胺烟酸治疗HBV再激活.

主要成果:

患者最初呈现了分离的抗HBc抗体 (HBsAg阴性,HBsAb阴性,HBcAb阳性) 和阴性HBVDNA.
在完成21个月的rituximab治疗后33个月发生了延迟的HBV重新激活.
肝炎病毒DNA水平显著增加,导致肝功能衰竭.
诺福维尔阿拉芬胺胺烟酸治疗导致9个月内无法检测到的HBVDNA.

结论:

在IAHBc患者中,在Rituximab停止后晚期可能发生HBV重新激活.
在接受免疫抑制治疗的患者中,IAHBc状态应促使对HBV重新激活保持警.
早期的抗病毒治疗对于控制HBV再激活和预防肝功能衰竭至关重要.

关键词:

乙型肝炎病毒的重新激活这就是Rituximab.诺福维尔 (tenofovir) 是一种胺酸.

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