HBV的再激活与ALEMTUZUMAB治疗

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Hepatitis B virus reactivation and alemtuzumab therapy.

Iannitto E, Minardi V, Calvaruso G, Mule A, Ammatuna E, Trapani RD, Ferraro
D, Abbadessa V, Craxi A, Stefano RD.

Department of Oncology, Haematology, and BMT Unit, University of Palermo,
Palermo, Italy.

Iannitto E, Minardi V, Calvaruso G, Mule A, Ammatuna E, Trapani RD, Ferraro
D, Abbadessa V, Craxi A, Stefano RD. Hepatitis B virus reactivation and
alemtuzumab therapy. Eur J Haematol 2005: 74: 254-258. (c) Blackwell
Munksgaard 2005.Abstract: Reactivation of hepatitis B virus infection in
subjects receiving cytotoxic treatment for heamatological malignancies
occurs in 21-53% of chronic HBsAg carriers and in an unknown number of HBsAg
negative subjects harbouring occult HBV infection. Immunotherapy with
alemtuzumab, a humanized monoclonal antibody against CD52 epitopes on
lymphocytes cells produces deep immunosuppression. We describe two subjects
with chronic lymphocytic leukaemia and occult HBV infection who developed a
virological and biochemical flare of hepatitis B following immunotherapy
with alemtuzumab. One of them developed full blown hepatitis with
seroreversion from anti-HBs to HBsAg after four weeks of alemtuzumab
therapy. Lamivudine (100 mg die) achieved a complete clinical recovery and
HBV-DNA clearance from blood within 8 weeks. The second patient (HBsAg and
HBV-DNA seronegative, anti-HBs and anti-HBc positive before treatment) was
kept under prophylaxis with lamivudine up to three months after alemtuzumab.
Two months after withdrawal of lamivudine, clinical and laboratory features
of acute hepatitis B developed. Lamivudine therapy was restarted and a
prompt recovery was obtained with HBsAg and HBV-DNA clearance.

PMID: 15693796 [PubMed - in process]