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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