Re-appearance of hepatitis B virus following therapy with rituximab for lymphoma is not rare in Japanese patients with past hepatitis B virus infection

February 7, 2011

http://www.ingentaconnect.com/content/mksg/liv/2011/00000031/00000003/art00010

Re-appearance of hepatitis B virus following therapy with rituximab for lymphoma

is not rare in Japanese patients with past hepatitis B virus infection

Authors: Watanabe, Masaaki1; Shibuya, Akitaka1; Tsunoda, Yuhko2; Danbara,

Mikio2; Ishii, Ryuji2; Ohsaka, Manabu2; Takada, Juichi1; Tanaka, Yoshiaki1;

Okuwaki, Yusuke1; Minamino, Tsutomu1; Hidaka, Hisashi1; Nakazawa, Takahide1;

Horie, Ryouichi2; Higashihara, Masaaki2; Koizumi, Wasaburo1

Source: Liver International, Volume 31, Number 3, March 2011 , pp. 340-347(8)

Publisher: Wiley-Blackwell

Abstract:

Background and aim:

De novo hepatitis B virus (HBV)-related hepatitis is a well-known fatal

complication following chemo-immunosuppressive therapy in patients with past HBV

infection (HB surface antigen and serum HBV DNA negative, but HB core antibody

and/or HB surface antibody positive). This research was conducted to evaluate

the incidence of and clinical features associated with re-appearance of serum

HBV DNA following chemo-immunosuppressive therapy in Japanese patients with past

HBV infection.

Methods:

This is a retrospective review. Forty-five patients with past HBV infection who

had received chemo-immunosuppressive therapy for haematological disease were

followed up for >6 months, to determine whether the serum test for HBV changed

from negative to positive (i.e. re-appearance of serum HBV DNA following

chemo-immunosuppressive therapy).

Results:

Re-appearance of serum HBV DNA was confirmed in five (20.8%) of the 24 patients

who had received treatment regimens containing rituximab, but in none of the 21

patients who had not received treatment regimens containing rituximab (P=0.035).

The HBV genotype could be determined in four of the five aforementioned

patients, and in all four, HBV genotype C, which is the most prevalent genotype

in Japan, was identified.

Conclusion:

This research showed that re-appearance of serum HBV DNA is not rare in Japanese

patients treated with chemotherapy regimens containing rituximab, and no other

factors related to such re-appearance of serum HBV DNA could be identified.

Well-designed clinical studies, including immunological and genetic analyses of

the host and of the HBV, are required for further elucidation.

Document Type: Research article

DOI: 10.1111/j.1478-3231.2010.02417.x

Affiliations: 1: Department of Gastroenterology, Kitasato University School of

Medicine, Sagamihara, Kanagawa, Japan 2: Department of Hematology, Kitasato

University School of Medicine, Sagamihara, Kanagawa, Japan

Publication date: 2011-03-01

February 7, 2011