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Shimizu D, Nomura K, Matsumoto Y, Ueda K, Yamaguchi K, Minami M, Itoh Y, Horiike S, Morita M, Taniwaki M, Okanoue T. Hepatitis B virus reactivation in a patient undergoing steroid-free chemotherapy. World J Gastroenterol 2004; 10(15): 2301-2302 [PMID: 15259089 DOI: 10.3748/wjg.v10.i15.2301]
Daisuke Shimizu, Kenichi Nomura, Yosuke Matsumoto, Kyoji Ueda, Shigeo Horiike, Masafumi Taniwaki, Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto 602-0841, Japan
Kanji Yamaguchi, Masahito Minami, Yoshito Itoh, Takeshi Okanoue, Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto 602-0841, Japan
Masuji Morita, School of Nursing, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto 602-0841, Japan
Masafumi Taniwaki, Clinical Molecular Genetics and Laboratory Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto 602-0841, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Kenichi Nomura, Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto 602-0841, Japan. nomuken@sun.kpu-m.ac.jp
Telephone: +81-75-251-5521 Fax: +81-75-251-0710
Received: March 15, 2004 Revised: April 3, 2004 Accepted: April 9, 2004 Published online: August 1, 2004
Abstract
A 62-year-old Japanese man who was positive for hepatitis B surface antigen (HBsAg) and anti-HBe antibody, underwent chemotherapy for non-Hodgkin’s lymphoma (NHL). Mutations were detected in the precore region (nt1896) of HBV. Because steroid-containing regimen may cause reactivation of hepatitis B virus (HBV) and hepatitis may progress to be fulminant after its withdrawal, we administered CHO (CPA, DOX and VCR) therapy and the patient obtained complete response. However, he developed acute exacerbation of hepatitis due to HBV reactivation. Recovery was achieved with lamivudine (100 mg/d) and plasma exchange. The present case suggests that acute exacerbation of hepatitis can occur with steroid-free regimen. Because the efficacy of the prophylactic use of lamivudine has been reported and the steroid enhances curability of malignant lymphoma, the steroid containing regimen with prophylaxis of lamivudine should be evaluated further.
