Thirot-Bidault Anne, Ben Mansour Jaata, Lambotte Olivier, Besson Caroline, Bou-Farah Rita, Pallier Coralie, Buffet Catherine
Service des maladies du foie et de l'appareil digestif, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Gastroenterol Clin Biol. 2007 Nov;31(11):1028-31. doi: 10.1016/s0399-8320(07)78326-4.
Hepatitis B reactivation after chemotherapy is well known when Ag HBs is positive. Recommendation is to give preventive antiviral treatment before starting chemotherapy. The reactivation when there is only an anti-HBc antibody is rare. We report the case of a woman who developed an hepatitis B reactivation two weeks after the end of a chemotherapy for a high grade non Hodgkin lymphoma. Before chemotherapy, hepatitis B virus serology was positive only for anti-HBc antibody and viral load was negative. She had a fulminant hepatitis with fatal issue although a treatment by lamivudine and adefovir was rapidly started. In the literature, only 13 cases of patients with positive anti body anti-HBc alone who developed an hepatitis B reactivation after chemotherapy have been reported.
当乙肝表面抗原（HBsAg）呈阳性时，化疗后乙肝再激活是众所周知的。建议在开始化疗前进行预防性抗病毒治疗。仅有抗-HBc抗体时发生再激活的情况较为罕见。我们报告了一名女性患者的病例，该患者在针对高级别非霍奇金淋巴瘤的化疗结束两周后发生了乙肝再激活。化疗前，乙肝病毒血清学检查仅抗-HBc抗体呈阳性，病毒载量为阴性。尽管迅速开始了拉米夫定和阿德福韦治疗，但她仍发生了暴发性肝炎并导致死亡。在文献中，仅报道了13例单独抗-HBc抗体阳性且化疗后发生乙肝再激活的患者病例。
