Reactivation of hepatitis B virus following rituximab-based regimens: a serious complication in both HBsAg-positive and HBsAg-negative patients.

Abstract

Hepatitis B virus (HBV) reactivation is a well-known complication of lymphoma treatment in the pre-rituximab era. This complication has not been as well studied, however, since monoclonal anti-CD20 antibody became the standard regimen for B cell lymphoma. In this retrospective study, 115 B cell lymphoma patients who received rituximab-containing therapy were analyzed. Of 15 hepatitis B surface antigen (HBsAg)-positive patients, five received lamivudine prophylaxis and did not develop HBV-related hepatitis during lymphoma treatment. Eight of ten HBV carriers without lamivudine prophylaxis experienced HBV-related hepatitis, including one fatal hepatic failure. Four (4.2%) of 95 HBsAg-negative patients developed de novo HBV-related hepatitis and two died of fulminant hepatitis. In conclusion, rituximab-based therapy may cause serious HBV-related complications and even death in both HBsAg-positive and HBsAg-negative patients.

• Authors: Sung-Nan Pei, Chien-Hung Chen, Chuan-Mo Lee, Ming-Chung Wang, Ming-Chun Ma, Tsung-Hui Hu, Ching-Yuan Kuo
• Journal: Annals of hematology (Ann Hematol) Vol. 89 Issue 3 Pg. 255-62 (Mar 2010) ISSN: 1432-0584 [Electronic] Germany
• PMID: 19697028 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Hepatitis B Surface Antigens
• Lamivudine
• Rituximab

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal (adverse effects)
• Antibodies, Monoclonal, Murine-Derived
• Female
• Hepatitis B (etiology, prevention & control)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B virus (drug effects, physiology)
• Humans
• Incidence
• Lamivudine (therapeutic use)
• Lymphoma, B-Cell (complications, drug therapy)
• Male
• Middle Aged
• Premedication
• Retrospective Studies
• Rituximab
• Virus Activation (drug effects)