Successful use of entecavir for a severe case of reactivation of hepatitis B virus following polychemotherapy containing rituximab

doi:10.1016/j.jhep.2009.07.012

Journal of Hepatology

Volume 51, Issue 6, December 2009, Pages 1091-1096

https://doi.org/10.1016/j.jhep.2009.07.012 Get rights and content

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Backgrounds/Aims

Hepatitis B virus (HBV) reactivation following treatment with rituximab has been reported in patients with either HBsAg-positive, or HBsAg-negative and anti-HBc positive infection. Patients with severe reactivation often have a fatal outcome despite treatment with lamivudine. The use of entecavir has not been reported in patients with severe HBV reactivation.

Methods

We present a case of a HBsAg-negative patient diagnosed with chronic lymphocytic leukemia who received a chemotherapeutic regimen that included rituximab, who subsequently presented with severe HBV reactivation with ascites, jaundice and coagulopathy and was treated with entecavir. A review of the literature and underlying HBV associated mutations are discussed.

Results

Entecavir produced a rapid and sustained suppression of HBV that was associated with rapid clinical improvement without any side effects.

Conclusion

Entecavir is an efficacious and safe treatment for severe HBV reactivation.

Abbreviations

HBV

hepatitis B virus

HBsAg

hepatitis B surface antigen

Keywords

Entecavir

HBV reactivation

Rituximab

Cited by (0)

^☆: The underlying research reported in this study was partially founded by the NIH (Grant No.: 5 T 32 DK007356-30 to M.J.S.). M.B. is a speaker and on the Advisory Board for Novartis, Gilead and Bristol Myers Squibb. R.E. is a speaker and on the Advisory Board for Gilead, Bristol Myers Squibb, Schering-Plough and Novartis. The other authors who have taken part in this study declared that they do not have anything to disclose regarding funding from industries or conflict of interest with respect to this manuscript.