奥瑞珠单抗治疗多发性硬化症后出现具有免疫逃逸突变的乙型肝炎病毒再激活
Reactivation of Hepatitis B Virus With Immune-Escape Mutations After Ocrelizumab Treatment for Multiple Sclerosis.
作者信息
Ciardi Maria R, Iannetta Marco, Zingaropoli Maria A, Salpini Romina, Aragri Marianna, Annecca Rosanna, Pontecorvo Simona, Altieri Marta, Russo Gianluca, Svicher Valentina, Mastroianni Claudio M, Vullo Vincenzo
机构信息
Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Rome, Italy.
Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
出版信息
Open Forum Infect Dis. 2018 Dec 26;6(1):ofy356. doi: 10.1093/ofid/ofy356. eCollection 2019 Jan.
Ocrelizumab is an anti-CD20 monoclonal antibody for the treatment of multiple sclerosis (MS) that is closely related to rituximab. We describe a case of hepatitis B virus (HBV) reactivation in an MS patient with resolved HBV infection receiving ocrelizumab. HBV reactivation was monitored with HBV-DNA and HBV surface antigen periodic assessment. Anti-HBV treatment with entecavir was started after HBV-DNA detection. Ocrelizumab can reactivate viral replication in patients with resolved HBV infection. HBV reactivation monitoring seems an effective and safe option for the management of these patients. More studies are needed to assess the optimal management of HBV reactivation in MS patients on ocrelizumab treatment.
奥瑞珠单抗是一种用于治疗多发性硬化症（MS）的抗CD20单克隆抗体，与利妥昔单抗密切相关。我们描述了一例接受奥瑞珠单抗治疗且乙肝病毒（HBV）感染已缓解的MS患者发生HBV再激活的病例。通过定期评估HBV-DNA和HBV表面抗原监测HBV再激活情况。在检测到HBV-DNA后开始使用恩替卡韦进行抗HBV治疗。奥瑞珠单抗可使HBV感染已缓解的患者重新激活病毒复制。监测HBV再激活似乎是管理这些患者的一种有效且安全的选择。需要更多研究来评估接受奥瑞珠单抗治疗的MS患者中HBV再激活的最佳管理方法。
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