Gozdas Hasan Tahsin, Arpaci Erkan
Hasan Tahsin Gozdas, Department of Infectious Diseases and Clinical Microbiology, Dr. Münif İslamoğlu Kastamonu State Hospital, 37100 Kastamonu, Turkey.
World J Gastroenterol. 2015 Sep 21;21(35):10251-2. doi: 10.3748/wjg.v21.i35.10251.
We read with interest the case report by Liu et al and the correspondence by Tuna et al regarding this case. Liu et al described hepatitis B virus (HBV) reactivation in a patient with non-Hodgkin's lymphoma after withdrawal of lamivudine prophylaxis. When HBV reactivation was observed three months after lamivudine withdrawal, entecavir 0.5 mg daily was started. HBV DNA level was moderately elevated (10(4) copies/mL) at that time. So, we could not understand why a potent antiviral like entecavir was required for this case. In addition to this, entecavir must be used at a dose of 1 mg in patients with prior prophylactic treatment with lamivudine. As stated by Tuna et al duration of lamivudine prophylaxis in this case might be insufficient and HBV reactivation might have occured for this reason. So, we suppose that resolution of HBV reactivation might also be achieved with lamivudine instead of entecavir in this case.
我们饶有兴趣地阅读了Liu等人的病例报告以及Tuna等人关于该病例的通信。Liu等人描述了一名非霍奇金淋巴瘤患者在停用拉米夫定预防治疗后发生乙型肝炎病毒(HBV)再激活的情况。在停用拉米夫定三个月后观察到HBV再激活时,开始每日服用0.5毫克恩替卡韦。当时HBV DNA水平中度升高(10⁴拷贝/毫升)。因此,我们不明白为何该病例需要使用像恩替卡韦这样强效的抗病毒药物。除此之外,对于曾接受拉米夫定预防性治疗的患者,恩替卡韦的使用剂量必须为1毫克。正如Tuna等人所述,该病例中拉米夫定预防治疗的持续时间可能不足,HBV再激活可能因此发生。所以,我们认为在该病例中,使用拉米夫定而非恩替卡韦也可能实现HBV再激活的缓解。