Kirito Keita, Sakamoto Minoru, Enomoto Nobuyuki
Department of Hematology/Oncology, University of Yamanashi, Japan.
Intern Med. 2016;55(10):1341-4. doi: 10.2169/internalmedicine.55.5529. Epub 2016 May 15.
Ruxolitinib is a useful treatment option for myelofibrosis since it effectively resolves splenomegaly and constitutional symptoms. After the widespread use of ruxolitinib outside of clinical trials, a series of case reports indicated a potential risk of ruxolitinib-associated opportunistic infections, including the reactivation of the hepatitis B virus (HBV). We herein report the case of a polycythemia vera patient who showed an elevation of HBV-DNA viral DNA with an elevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) after the initiation of ruxolitinib. Anti-viral therapy with entecavir was immediately started and the HBV viral load thereafter decreased with an improvement of the liver function. Physicians should thus be aware of the potential risk of ruxolitinib-associated HBV reactivation.
鲁索替尼是骨髓纤维化的一种有效治疗选择，因为它能有效缓解脾肿大和全身症状。在鲁索替尼在临床试验之外广泛使用后，一系列病例报告表明鲁索替尼相关机会性感染存在潜在风险，包括乙型肝炎病毒（HBV）再激活。我们在此报告一例真性红细胞增多症患者，该患者在开始使用鲁索替尼后出现HBV-DNA病毒DNA升高，同时天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）升高。立即开始使用恩替卡韦进行抗病毒治疗，此后HBV病毒载量下降，肝功能改善。因此，医生应意识到鲁索替尼相关HBV再激活的潜在风险。
