Reactivation of Occult Hepatitis B Virus Infection 27 Months after the End of Chemotherapy Including Rituximab for Malignant Lymphoma

Intern Med. 2017;56(15):1967-1971. doi: 10.2169/internalmedicine.56.8233. Epub 2017 Aug 1.

Abstract

A 68-year-old man with occult hepatitis B virus (HBV) infection was diagnosed with malignant lymphoma and achieved complete remission after treatment with a chemotherapy regimen including rituximab for 5 months. Entecavir (ETV) was also used during and after chemotherapy and was ended at 14 months after chemotherapy. However, reactivation of HBV was observed in blood tests, which showed not only elevation of HBV-DNA but also HBsAg and HBeAg, at 27 months after the end of chemotherapy. After restarting ETV, the HBV-DNA levels immediately subsided. In addition, anti-HBs became and remained positive at 31 months after chemotherapy. ETV was re-discontinued at 36 months after chemotherapy.

Keywords: HBV; entecavir; reactivation; rituximab.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Guanine / administration & dosage
  • Guanine / analogs & derivatives*
  • Guanine / therapeutic use
  • Hepatitis B / drug therapy*
  • Hepatitis B / physiopathology
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B e Antigens
  • Hepatitis B virus / physiology*
  • Humans
  • Lymphoma / drug therapy*
  • Male
  • Rituximab / administration & dosage
  • Rituximab / therapeutic use*
  • Virus Activation

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antiviral Agents
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B e Antigens
  • Rituximab
  • entecavir
  • Guanine