Hepatitis B Virus (HBV) Reactivation Following Immunosuppression in HBsAg(+) Carriers
Keywords:
HBV reactivation, immunosuppression, chemotherapy, Rituximab, HBsAg( ) carriersAbstract
HBV reactivation occurs in HBsAg(+) carriers who have undergone immunosuppressive therapy such as Rituximab treatment, chemotherapy or corticosteroids for malignancy or other diseases that require immunosuppression. Immunosuppression induces rapid HBV replication and increasingly infects hepatocytes. Reactivation usually occurs after discontinuation or withdrawal of immunosuppression when the immune system is reconstituted and attacks infected hepatocytes. This leads to acute hepatitis characterized by increased levels of alanineaminotransferase (ALT) and serum HBV DNA. Rarely it can be life threatening.
References
Kusumoto, S, Tanaka Y, Ueda R, et al. Reactivation of hepatitis B virus following rituximab-plus-steroid combination chemotherapy. J Gastroenterol. 2011; 46:9-16.
Hoofnagle, JH. Dusheiko GM, Schafer DF, et al. Reactivation of Chronic Hepatitis B Virus Infection by Cancer Chemotherapy. Ann Intern Med. 1982; 96:447-449.
Mastroianni CM, Lichtner M, Citton R, et al. Current trends in management of hepatitis B virus reactivation in the biologic therapy era. World J Gastroenterol. 2011; 17: 3881-3887.
Cohen C, Evans AA, London WT, et al. Underestimation of chronic hepatitis B virus infection in the United States of America. J Viral Hepatol. 2008;15:12-13.
Kim, WR. Epidemiology of hepatitis B in the United States. Hepatology. 2009;49 (5 Suppl):S28-34.
Cohen C, Holmberg SD, McMahon BJ, et al. Is chronic hepatitis B being undertreated in the United States? J Viral Hepat. 2011;18:377- 383.
Evens AM, Jovanovic BD, Su Y-C, et al. Rituximab-associated hepatitis B virus (HBV) reactivation in lymphoproliferative diseases: meta-analysis and examination of FDA safety reports. Ann Oncol. 2011;22:1170-1180.
Chou, CH, Chen P-J, Lee P-H, er al. Radiation-Induced Hepatitis B Virus Reactivation in Liver Mediated by the Bystander Effect from Irradiated Endothelial Cells. Clin Cancer Res. 2007; 13: 851-857.
Belyakov OV, Mitc hell SA, Parikh D, et al. Biological effects in unirradiated human tissue induced by radiation damage up to 1mm away. ProcN atl Acad Sci USA 2005;102:1420-1428.
Cheng AL,Hsiung CA, Su IJ, et al. Steroid-freec hemotherapy decreases risk of hepatitis B virus (HBV) reactivation in HBV-carriers with lymphoma. Hepatology 2003;37:1320-1328.
Locarnini S. Molecular virology of hepatitis B virus. Semin Liver Dis 2004;24 Suppl 1:3-10.
Cheng AL, Hsiung CA, Su IJ, et al. Lymphoma Committee of Taiwan Cooperative Oncology Group. Steroid-free chemotherapy decreases risk of hepatitis B virus (HBV) reactivation in HBV-carriers with lymphoma. Hepatology. 2003;37:1320-1328.
Nair PV, Tong MJ, Stevenson D, et al. Effects of shortterm, high-dose prednisone treatment of patients with HBsAg-positive chronic active hepatitis. Liver 1985;5:8-12.
Watanabe K, Takase K, Ohno S, et al. Reactivation of hepatitis B virus in a hepatitis B surface antigen-negative patient with rheumatoid arthritis treated with methotrexate. Mod Rheumatol. 2012;22:470-473.
Lok ASF, McMahon BJ. Chronic hepatitis B: Update 2009. Hepatology. 2009;45:507-539.
European Association for the Study of Liver Disease. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. J Hepatol. 2012;57:167-185.
Reddy KR, Beavers KL, Hammond SP, et al. American Gastroenterological Association Institute Guideline on the prevention of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148:215-219.
Liaw Y-F, Kao J-H, Piratvisuth T, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: 1 2012 update. Hepatol Int. 2012;6:531-561.
Tong MJ, Pan CQ, Hann HW, et al. The management of chronic hepatitis B in Asian Americans. Dig Dis Sci. 2011;56:3143-3162.
Civan J, Hann HW. Giving rituximab in patients with occult or resolved hepatitis B virus infection: are the current guidelines good enough? Expert Opin Drug Saf. 2015;14:1-11.
Chae HB, Hann HW. Baseline HBV DNA level is the most important factor associated with virologic breakthrough in chronic hepatitis B treated with lamivudine. World J Gastroenterol. 2007;14; 13(30): 4085-4090.
Hoofnagle, JH. Dusheiko GM, Schafer DF, et al. Reactivation of Chronic Hepatitis B Virus Infection by Cancer Chemotherapy. Ann Intern Med. 1982; 96:447-449.
Mastroianni CM, Lichtner M, Citton R, et al. Current trends in management of hepatitis B virus reactivation in the biologic therapy era. World J Gastroenterol. 2011; 17: 3881-3887.
Cohen C, Evans AA, London WT, et al. Underestimation of chronic hepatitis B virus infection in the United States of America. J Viral Hepatol. 2008;15:12-13.
Kim, WR. Epidemiology of hepatitis B in the United States. Hepatology. 2009;49 (5 Suppl):S28-34.
Cohen C, Holmberg SD, McMahon BJ, et al. Is chronic hepatitis B being undertreated in the United States? J Viral Hepat. 2011;18:377- 383.
Evens AM, Jovanovic BD, Su Y-C, et al. Rituximab-associated hepatitis B virus (HBV) reactivation in lymphoproliferative diseases: meta-analysis and examination of FDA safety reports. Ann Oncol. 2011;22:1170-1180.
Chou, CH, Chen P-J, Lee P-H, er al. Radiation-Induced Hepatitis B Virus Reactivation in Liver Mediated by the Bystander Effect from Irradiated Endothelial Cells. Clin Cancer Res. 2007; 13: 851-857.
Belyakov OV, Mitc hell SA, Parikh D, et al. Biological effects in unirradiated human tissue induced by radiation damage up to 1mm away. ProcN atl Acad Sci USA 2005;102:1420-1428.
Cheng AL,Hsiung CA, Su IJ, et al. Steroid-freec hemotherapy decreases risk of hepatitis B virus (HBV) reactivation in HBV-carriers with lymphoma. Hepatology 2003;37:1320-1328.
Locarnini S. Molecular virology of hepatitis B virus. Semin Liver Dis 2004;24 Suppl 1:3-10.
Cheng AL, Hsiung CA, Su IJ, et al. Lymphoma Committee of Taiwan Cooperative Oncology Group. Steroid-free chemotherapy decreases risk of hepatitis B virus (HBV) reactivation in HBV-carriers with lymphoma. Hepatology. 2003;37:1320-1328.
Nair PV, Tong MJ, Stevenson D, et al. Effects of shortterm, high-dose prednisone treatment of patients with HBsAg-positive chronic active hepatitis. Liver 1985;5:8-12.
Watanabe K, Takase K, Ohno S, et al. Reactivation of hepatitis B virus in a hepatitis B surface antigen-negative patient with rheumatoid arthritis treated with methotrexate. Mod Rheumatol. 2012;22:470-473.
Lok ASF, McMahon BJ. Chronic hepatitis B: Update 2009. Hepatology. 2009;45:507-539.
European Association for the Study of Liver Disease. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. J Hepatol. 2012;57:167-185.
Reddy KR, Beavers KL, Hammond SP, et al. American Gastroenterological Association Institute Guideline on the prevention of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148:215-219.
Liaw Y-F, Kao J-H, Piratvisuth T, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: 1 2012 update. Hepatol Int. 2012;6:531-561.
Tong MJ, Pan CQ, Hann HW, et al. The management of chronic hepatitis B in Asian Americans. Dig Dis Sci. 2011;56:3143-3162.
Civan J, Hann HW. Giving rituximab in patients with occult or resolved hepatitis B virus infection: are the current guidelines good enough? Expert Opin Drug Saf. 2015;14:1-11.
Chae HB, Hann HW. Baseline HBV DNA level is the most important factor associated with virologic breakthrough in chronic hepatitis B treated with lamivudine. World J Gastroenterol. 2007;14; 13(30): 4085-4090.
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Published
2016-01-15
How to Cite
Wu, R. M., & Hann, H.-W. L. (2016). Hepatitis B Virus (HBV) Reactivation Following Immunosuppression in HBsAg(+) Carriers. North American Journal of Medicine and Science, 8(4). Retrieved from https://najms.com/index.php/najms/article/view/83
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Case Report
