Mesut SEZİKLİ, ZÜLEYHA AKKAN ÇETİNKAYA, GÖKTUĞ ŞİRİN, Gül TOKGÖZ, Esra YEŞİLYURT, Selen BAŞTAŞ ŞİPAL

Anti-HBs pozitif hastada otolog kemik iliği transplantasyonu sonrası hepatit-B alevlenmesi

Hepatit B virüs enfeksiyonu, immünsüpresiv tedavi alanlarda önemli bir klinik problemdir. Hepatit B yüzey antijeni negatif hastalarda, he- patit B yüzey antikoru ve hepatit B çekirdek antikoru immünglobulin G pozitifliği de hepatit B virüsü reaktivasyonu için kontrol edilmelidir. Bu yazımızda otolog kemik iliği transplantasyonu sonrası hepatit B virüsü reaktivasyonu gelişen ve transplantasyon öncesi hepatit B yüzey antijeni negatifliğine rağmen hepatit B yüzey antikoru ve hepatit B çekirdek an- tikoru immünglobulin G pozitifliği gözden kaçan bir olgu sunulmuştur.

Hepatitis B virus reactivation following autologous hematopoietic stem cell transplantation in anti-HBs-positive patients

Hepatitis B virus infection is an important problem in patients receiving immunosuppressive therapy. Thus, before administering immunosup- pressive therapy, patients must be tested for hepatitis B virus infection. Besides hepatitis B surface antigen, patients should also be tested for hepatitis B surface antibody and hepatitis B core antibody immunoglob- ulin G. We report a case of a patient negative for hepatitis B surface an- tigen but positive for hepatitis B surface antibody and hepatitis B core antibody immunoglobulin G, who later developed hepatitis B virus reac- tivation following autologous hematopoietic stem cell transplantation.

PDF

___

Firpi RJ, Nelson DR. Viral hepatitis: manifestations and strategy. Hematology Am Soc Hematol Educ Program. 2006:375-80.
Lee WM. Hepatitis B virus infection. N Engl J Med 1997;337:1733-45.
Chen MH, Hsiao LT, Chiou TJ, et al. High prevalence of occult hep- atitis B virus infection in patients with B cell non-Hodgkin's lympho- ma. Ann Hematol 2008;87:475-80.
Nagington J. Reactivation of hepatitis B after transplantation oper- ations. Lancet. 1977;1:558-60.
Nordbo SA, Skaug K, Holter E, et al. Reactivation of hepatitis B virus infection in an anti-HBc and anti-HBs positive patient after allogene- ic bone marrow transplantation. Eur J Haematol 2000;65:86-7.
Koo YX, Tay M, Teh YE, et al. Risk of hepatitis B virus (HBV) reacti- vation in hepatitis B surface antigen negative/hepatitis B core anti- body positive patients receiving rituximab-containing combination chemotherapy without routine antiviral prophylaxis. Ann Hematol 2011;90:1219-23.
Yeo W, Chan TC, Leung NW, et al. Hepatitis B virus reactivation in lymphoma patients with prior resolved hepatitis B undergo- ing anticancer therapy with or without rituximab. J Clin Oncol 2009;27:605-11.
Hwang JP, Fisch MJ, Zhang H, et al. Low rates of hepatitis B virus screening at the onset of chemotherapy. J Oncol Pract 2012;8:e32-9.
Hwang JP, Fisch MJ, Lok AS, et al. Trends in hepatitis B virus screen- ing at the onset of chemotherapy in a large US cancer center. BMC Cancer 2013;13:534.
Tillmann HL, Zachou K, Dalekos GN. Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat? Liver Int 2012;32:544-53.
Hui CK, Lie A, Au WY, et al. Effectiveness of prophylactic Anti-HBV therapy in allogeneic hematopoietic stem cell transplantation with HBsAg positive donors. Am J Transplant 2005;5:1437-45.
Dai MS, Chao TY. Lamivudine therapy in HBsAg-carrying breast cancer patients undergoing chemotherapy: prophylactic or pre- emptive? Breast Cancer Res Treat 2005;92:95-6.
Hui CK, Cheung WW, Au WY, et al. Hepatitis B reactivation after withdrawal of preemptive lamivudine in patients with haemato- logical malignancy on completion of cytotoxic chemotherapy. Gut. 2005;54:1597-603.
Leaw SJ, Yen CJ, Huang WT, et al. Preemptive use of interferon or lamivudine for hepatitis B reactivation in patients with aggressive lymphoma receiving chemotherapy. Ann Hematol 2004;83:270-5.
Yeo W, Chan PK, Ho WM, et al. Lamivudine for the prevention of hepatitis B virus reactivation in hepatitis B s-antigen seropositive cancer patients undergoing cytotoxic chemotherapy. J Clin Oncol 2004;22:927-34.
Lau GK, Yiu HH, Fong DY, et al. Early is superior to deferred pre- emptive lamivudine therapy for hepatitis B patients undergoing chemotherapy. Gastroenterology 2003;125:1742-9.
Yeo W, Ho WM, Hui P, et al. Use of lamivudine to prevent hepatitis B virus reactivation during chemotherapy in breast cancer patients. Breast Cancer Res Treat 2004;88:209-15.
Manzano-Alonso ML, Castellano-Tortajada G. Reactivation of hepa- titis B virus infection after cytotoxic chemotherapy or immunosup- pressive therapy. World J Gastroenterol 2011;17:1531-7.