Temel Tuncer, Gunduz Eren, Sadigova Esmira, Uskudar Teke Hava, Meric Ozgenel Safak, Harmanci Ozakyol Aysegul
Department of Gastroenterology, Eskisehir Osmangazi University, Eskisehir, Turkey.
Department of Hematology, Eskisehir Osmangazi University, Eskisehir, Turkey.
Euroasian J Hepatogastroenterol. 2015 Jul-Dec;5(2):112-114. doi: 10.5005/jp-journals-10018-1147. Epub 2016 Jul 9.
Hepatitis B virus (HBV) reactivation with imatinib, a tyrosine kinase inhibitor, has been reported in chronic myeloid leukemia. Nilotinib is a more potent second generation tyrosine kinase inhibitor and it inhibits the Src-family kinase LCK and hamper proliferation and function of CD8 (+) T lymphocytes. CD8 (+) T lymphocytes are the main cellular subset responsible for viral clearance in patients with HBV infection. We report a case of HBV reactivation under treatment with nilotinib. Fatal HBV reactivation is not usually related to death in chronic myeloid leukemia patients who have an expectation of longevity with well-tolerated oral drugs. Thus, screening for latent chronic HBV infections including assessment of hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc antibody) and antibody to hepatitis B surface antigen (anti-HBs), especially at countries with intermediate and high prevalence of HBsAg is warranted. Treatment with nucleoside analogs and close monitoring may be life-saving in this context.
Temel T, Gunduz E, Sadigova E, Teke HU, Ozgenel SM, Ozakyol AH. Hepatitis B Virus Reactivation under Treatment with Nilotinib. Euroasian J Hepato-Gastroenterol 2015;5(2):112-114.
在慢性髓性白血病中，已有使用酪氨酸激酶抑制剂伊马替尼导致乙型肝炎病毒（HBV）再激活的报道。尼罗替尼是一种更强效的第二代酪氨酸激酶抑制剂，它可抑制Src家族激酶LCK，并阻碍CD8(+) T淋巴细胞的增殖和功能。CD8(+) T淋巴细胞是HBV感染患者中负责病毒清除的主要细胞亚群。我们报告了1例接受尼罗替尼治疗期间发生HBV再激活的病例。致命性HBV再激活通常与慢性髓性白血病患者的死亡无关，这些患者预期可通过耐受性良好的口服药物长期存活。因此，有必要筛查潜在的慢性HBV感染，包括评估乙型肝炎表面抗原（HBsAg）、乙型肝炎核心抗体（抗-HBc抗体）和乙型肝炎表面抗体（抗-HBs），尤其是在HBsAg中等和高流行率的国家。在这种情况下，使用核苷类似物治疗并密切监测可能挽救生命。
Temel T, Gunduz E, Sadigova E, Teke HU, Ozgenel SM, Ozakyol AH. 尼罗替尼治疗期间的乙型肝炎病毒再激活。《欧亚肝脏胃肠病学杂志》2015年；5(2):112 - 114。
