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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.

PMID:23935355
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3738290/
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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Hepatitis B reactivation in a patient with rheumatoid arthritis with antibodies to hepatitis B surface antigen treated with rituximab.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。
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本文引用的文献

1
EASL clinical practice guidelines: Management of chronic hepatitis B virus infection.欧洲肝脏研究学会临床实践指南:慢性乙型肝炎病毒感染的管理
J Hepatol. 2012 Jul;57(1):167-85. doi: 10.1016/j.jhep.2012.02.010. Epub 2012 Mar 20.
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Current trends in management of hepatitis B virus reactivation in the biologic therapy era.生物治疗时代乙型肝炎病毒再激活的管理现状。
World J Gastroenterol. 2011 Sep 14;17(34):3881-7. doi: 10.3748/wjg.v17.i34.3881.
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Risk of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen negative/hepatitis B core antibody positive patients receiving rituximab-containing combination chemotherapy without routine antiviral prophylaxis.乙肝表面抗原阴性/乙肝核心抗体阳性患者接受利妥昔单抗联合化疗而未常规进行抗病毒预防时乙型肝炎病毒(HBV)再激活的风险。
Ann Hematol. 2011 Oct;90(10):1219-23. doi: 10.1007/s00277-011-1241-0. Epub 2011 Apr 26.
4
Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis.类风湿关节炎患者应用利妥昔单抗的更新共识声明。
Ann Rheum Dis. 2011 Jun;70(6):909-20. doi: 10.1136/ard.2010.144998. Epub 2011 Mar 6.
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Rituximab-associated hepatitis B virus (HBV) reactivation in lymphoproliferative diseases: meta-analysis and examination of FDA safety reports.利妥昔单抗相关的乙型肝炎病毒(HBV)再激活在淋巴增生性疾病中的作用:荟萃分析和 FDA 安全报告检查。
Ann Oncol. 2011 May;22(5):1170-1180. doi: 10.1093/annonc/mdq583. Epub 2010 Nov 29.
6
Reactivation of hepatitis B virus following rituximab-plus-steroid combination chemotherapy.利妥昔单抗联合激素化疗后乙型肝炎病毒再激活。
J Gastroenterol. 2011 Jan;46(1):9-16. doi: 10.1007/s00535-010-0331-4. Epub 2010 Oct 6.
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Hepatitis B reactivation after chemotherapy: two decades of clinical research.乙型肝炎化疗后再激活:二十年来的临床研究。
Hepatol Int. 2008 Jun;2(2):152-62. doi: 10.1007/s12072-008-9056-3. Epub 2008 Mar 5.
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Is screening for hepatitis B and hepatitis C useful in patients with recent-onset polyarthritis? The ESPOIR cohort study.对近期发病的多关节炎患者进行乙型肝炎和丙型肝炎筛查是否有用?ESPOIR队列研究。
J Rheumatol. 2009 Jul;36(7):1407-13. doi: 10.3899/jrheum.081308. Epub 2009 Jun 16.
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National Institutes of Health Consensus Development Conference Statement: management of hepatitis B.美国国立卫生研究院共识发展会议声明:乙型肝炎的管理
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Screening, prevention and treatment of viral hepatitis B reactivation in patients with haematological malignancies.血液系统恶性肿瘤患者乙型肝炎病毒再激活的筛查、预防及治疗
Br J Haematol. 2007 Mar;136(5):699-712. doi: 10.1111/j.1365-2141.2006.06465.x.