Hasan Fariha, Banatwala Umm E Salma Shabbar, Gandhi Tanay-Veer, Gaisinskaya Polina, Capanescu Cristina
Department of Internal Medicine, Cooper University Hospital, Camden, NJ, USA.
Department of Internal Medicine, Dow Medical College, Karachi, Pakistan.
SAGE Open Med Case Rep. 2025 Jul 13;13:2050313X251356397. doi: 10.1177/2050313X251356397. eCollection 2025.
There are limited reports of concomitant infection with hepatitis B virus, Epstein-Barr virus, and cytomegalovirus. This case represents the first documented instance of such a triple infection in an individual with metastatic renal cell carcinoma undergoing combined immunotherapy with ipilimumab and nivolumab. This is the case of a 40-year-old male patient with past medical history notable for type 1 diabetes mellitus and renal cell carcinoma who exhibited liver function abnormalities suggestive of viral liver injury, particularly due to hepatitis B virus reactivation. Interestingly, despite the triple infection, the patient experienced relatively mild disease progression, with liver function tests showing a downward trend, likely due to timely intervention with tenofovir. This case highlights the complexity of viral interactions in immunocompromised patients and emphasizes the need for further research into optimal management strategies.
关于乙型肝炎病毒、爱泼斯坦-巴尔病毒和巨细胞病毒合并感染的报道有限。该病例是首例记录在案的转移性肾细胞癌患者在接受伊匹单抗和纳武单抗联合免疫治疗时出现这种三重感染的情况。这是一名40岁男性患者,既往病史有1型糖尿病和肾细胞癌,其肝功能异常提示病毒性肝损伤,尤其是由于乙型肝炎病毒再激活。有趣的是,尽管有三重感染,但患者疾病进展相对较轻,肝功能检查呈下降趋势,这可能得益于替诺福韦的及时干预。该病例突出了免疫功能低下患者中病毒相互作用的复杂性,并强调了对最佳管理策略进行进一步研究的必要性。