Anti-HBs-Positive Liver Failure Due to Hepatitis B Virus Reactivation Induced by Rituximab

Toshiki Sera; Yoichi Hiasa; Kojiro Michitaka; Ichiro Konishi; Kana Matsuura; Yoshio Tokumoto; Bunzo Matsuura; Takeshi Kajiwara; Toshikazu Masumoto; Norio Horiike; Morikazu Onji

doi:10.2169/internalmedicine.45.1590

ORIGINAL ARTICLES

Anti-HBs-Positive Liver Failure Due to Hepatitis B Virus Reactivation Induced by Rituximab

Toshiki Sera, Yoichi Hiasa, Kojiro Michitaka, Ichiro Konishi, Kana Matsuura, Yoshio Tokumoto, Bunzo Matsuura, Takeshi Kajiwara, Toshikazu Masumoto, Norio Horiike, Morikazu Onji

Author information

Toshiki Sera
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Yoichi Hiasa
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Kojiro Michitaka
Department of Endoscopic Medicine, Ehime University Graduate School of Medicine
Ichiro Konishi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Kana Matsuura
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Yoshio Tokumoto
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Bunzo Matsuura
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Takeshi Kajiwara
Toshikazu Masumoto
Norio Horiike
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Morikazu Onji
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine

Keywords: hepatitis B virus, reactivation, rituximab

JOURNAL OPEN ACCESS

2006 Volume 45 Issue 11 Pages 721-724

DOI https://doi.org/10.2169/internalmedicine.45.1590

Details

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.

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