一名患有类风湿关节炎且乙肝表面抗原抗体阳性的患者在接受利妥昔单抗治疗后发生乙肝再激活。
Hepatitis B reactivation in a patient with rheumatoid arthritis with antibodies to hepatitis B surface antigen treated with rituximab.
作者信息
Gigi E, Georgiou T, Mougiou D, Boura P, Raptopoulou-Gigi M
机构信息
Liver Unit, 2nd Department of Internal Medicine, Hippokratio Hospital.
出版信息
Hippokratia. 2013 Jan;17(1):91-3.
Abstract
Hepatitis B virus (HBV) can still be found within the hepatocytes after its clearance and the control of viral replication depends on the immune response. However during immunosuppression, seroconversion of HBsAg has been described followed by disease reactivation. Hepatitis B virus reactivation represents an emerging cause of liver disease in patients undergoing treatment with biologic agents and in particular, by the use of rituximab (anti-CD20) and alemtuzumab (anti-CD52) that cause profound and long-lasting immunosuppression. We describe a case of a 64-year old female patient with rheumatoid arthritis and resolved HBV infection, who experienced a severe hepatitis B reactivation after the administration of rituximab.
摘要
乙肝病毒（HBV）在清除后仍可在肝细胞内被发现，病毒复制的控制取决于免疫反应。然而，在免疫抑制期间，已有HBsAg血清学转换后疾病再激活的报道。乙肝病毒再激活是接受生物制剂治疗的患者，特别是使用导致深度和持久免疫抑制的利妥昔单抗（抗CD20）和阿仑单抗（抗CD52）治疗的患者发生肝病的一个新原因。我们描述了一例64岁患有类风湿性关节炎且乙肝感染已治愈的女性患者，在使用利妥昔单抗后发生了严重的乙肝再激活。
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