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학술저널
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저널정보
대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology 제19권 제1호
발행연도
2013.1
수록면
51 - 59 (9page)

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Background/Aims: The widespread use of cytotoxic chemotherapy and immunosuppressants has resulted in reactivation of hepatitis B virus (HBV) recently becoming an issue. Although rituximab (an anti-CD20 monoclonal antibody) has revolutionized the treatment of lymphoma, recent reports have suggested that rituximab therapy increases the risk of viral-mediated complications, and particularly HBV reactivation. This study analyzed real clinical practice data for rituximab-related HBV reactivation. Methods: Between January 2005 and December 2011, 169 patients received treatment with rituximab. Screening status of the HBV infection and frequency of preemptive therapy were determined in these patients, and the clinical features of HBV reactivation were analyzed. Results: Seventy-nine of the 169 patients with chronic or past HBV infection were selected for evaluation of HBV reactivation. Of the 90 patients who were excluded, 22 (13.0%) were not assessed for HBsAg and anti-HBc, and 14 (8.3%)were not assessed for anti-HBc due to seronegativity for HBsAg. The selected patients were divided into those with chronic HBV infection (n=12) and those with past HBV infection (n=67); six patients (7.6%) experienced HBV reactivation. Eight patients received preemptive therapy, but three patients (37.5%) underwent HBV reactivation. Although HBsAg seropositivity was an independent risk factor for HBV reactivation (P=0.038), of the six patients with HBV reactivation,two (33.3%) had past HBV infection and three (50%) died of liver failure. Conclusions: The findings of this study demonstrate that adherence to guidelines for screening and preemptive therapy for HBV reactivation was negligent among the included cohort. Attention should be paid to HBV reactivation in patients with past as well as chronic HBV infection during and after rituximab therapy. (Clin Mol Hepatol 2013;19:51-59)
#Hepatitis B virus #Immunosuppressant #Rituximab

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참고문헌 (24)

참고문헌 신청
Aksoy S / 2007 / Rituximab-related viral infections in lymphoma patients / Leuk Lymphoma 48 : 1307 ~ 1312 google schola Dillon R / 2008 / Fatal reactivation of hepatitis B after chemotherapy for lymphoma / BMJ 337 : a423 ~ google schola European Association For The Study Of The Liver / 2009 / EASL Clinical Practice Guidelines: management of chronic hepatitis B / J Hepatol 50 : 227 ~ 242 google schola Gurcan HM / 2009 / A review of the current use of rituximab in autoimmune diseases / Int Immunopharmacol 9 : 10 ~ 25 google schola Hui CK / 2006 / Kinetics and risk of de novo hepatitis B infection in HBsAg-negative patients undergoing cytotoxic chemotherapy / Gastroenterology 131 : 59 ~ 68 google schola

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