Galbraith R M, Eddleston A L, Williams R, Zuckerman A J
Lancet. 1975 Sep 20;2(7934):528-30. doi: 10.1016/s0140-6736(75)90897-1.
In three patients with malignant disease HBsAg was detected in the serum at least 6 months before the development of acute hepatitis type B, which in each case followed a fulminant course to death. It is suggested that suppression of the normal immunological responses to hepatitis-B viral antigens by cytotoxic drug therapy permitted widespread infection of hepatocytes. Subsequently, upon withdrawal of these drugs, recovery of immunocompetence resulted in rapid destruction of all infected hepatocytes and massive liver damage. Screening for HBsAg before cytotoxic drug therapy, careful monitoring of liver function during its withdrawal, and prompt treatment with corticosteroids should abnormalities occur may prevent this unfortunate sequence of events.
在3例恶性疾病患者中，在急性乙型肝炎发生前至少6个月血清中检测到HBsAg，每例均呈暴发性病程并死亡。提示细胞毒性药物治疗抑制了对乙型肝炎病毒抗原的正常免疫反应，从而使肝细胞广泛感染。随后，停用这些药物后，免疫能力的恢复导致所有受感染肝细胞迅速破坏和严重肝损伤。在细胞毒性药物治疗前筛查HBsAg，在停药期间仔细监测肝功能，一旦出现异常及时用皮质类固醇治疗，可能预防这一不幸的事件序列。
