| Hepatitis B virus reactivation in a patient undergoing steroid-free chemotherapy |
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| 作者姓名： | Daisuke Shimizu Kenichi Nomura Yosuke Matsumoto Kyoji Ueda Kanji Yamaguchi Masahito Minami Yoshito Itoh Shigeo Horiike Masuji Morita Masafumi Taniwaki Takeshi Okanoue |
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| 作者单位： | Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Hematology and Oncology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Hematology and Oncology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Hematology and Oncology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Gastroenterology and Hepatology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Gastroenterology and Hepatology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Gastroenterology and Hepatology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Hematology and Oncology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，School of Nursing，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Hematology and Oncology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan Clinical Molecular Genetics and Laboratory Medicine，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan，Molecular Gastroenterology and Hepatology，Kyoto Prefectural University of Medicine Graduate School of Medical Science，Kyoto 602-0841，Japan |
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| 摘 要： | A 62-year-old Japanese man who was positive for hepatitisB surface antigen(HBsAg)and anti-HBe antibody,underwentchemotherapy for non-Hodgkin's lymphoma(NHL).Mutationswere detected in the precore region(nt1896)of HBV.Because steroid-containing regimen may cause reactivationof hepatitis B virus(HBV)and hepatitis may progress to befulminant after its withdrawal,we administered CHO(CPA,DOX and VCR)therapy and the patient obtained completeresponse.However,he developed acute exacerbation ofhepatitis due to HBV reactivation.Recovery was achievedwith lamivudine(100 mg/d)and plasma exchange.Thepresent case suggests that acute exacerbation of hepatitiscan occur with steroid-free regimen.Because the efficacyof the prophylactic use of lamivudine has been reportedand the steroid enhances curability of malignant lymphoma,the steroid containing regimen with prophylaxis oflamivudine should be evaluated further.
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