Abstract
A 59-year-old man developed acute hepatitis with reactivated hepatitis B virus (HBV) following administration of rituximab (anti-CD20 monoclonal antibody). The patient was diagnosed with malignant lymphoma in 1998, and virus marker testing indicated HBV surface antigen (HBsAg)-negative and anti-HBs antibody (anti-HBs)-positive results when chemotherapy including rituximab was started. Levels of aminotransferases were elevated, and HBsAg results turned positive. Despite therapy for late-onset hepatic failure, the patient died. Rituximab appears likely to have induced HBV reactivation in this case. Anti-viral agents should be administered for both HBsAg-positive and anti-HBs-positive patients who are scheduled to receive rituximab.
MeSH terms
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Antibodies, Monoclonal / adverse effects*
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Antibodies, Monoclonal / therapeutic use
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Antibodies, Monoclonal, Murine-Derived
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Antiviral Agents / therapeutic use
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Hepatitis B / blood
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Hepatitis B / chemically induced*
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Hepatitis B / complications
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Hepatitis B Antibodies / blood*
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Hepatitis B Surface Antigens / blood
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Hepatitis B virus / drug effects
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Hepatitis B virus / immunology
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Hepatitis B virus / physiology*
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Humans
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Immunologic Factors / adverse effects*
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Immunologic Factors / therapeutic use
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Liver Failure / blood
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Liver Failure / immunology*
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Liver Failure / prevention & control
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Lymphoma / drug therapy
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Male
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Middle Aged
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Rituximab
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Transaminases / blood
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Antiviral Agents
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Hepatitis B Antibodies
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Hepatitis B Surface Antigens
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Immunologic Factors
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Rituximab
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Transaminases