6533b7d4fe1ef96bd1263316
RESEARCH PRODUCT
Hepatitis B virus reactivation and alemtuzumab therapy
Iannitto EmilioMinardi VivianaCalvaruso GiuseppinaMulè AntoninoAmmatuna EmanueleDi Trapani RosaTrapani Rosa DFerraro DonatellaAbbadessa VincenzoAntonio CraxìDi Stefano RosaStefano Rosa Dsubject
MaleSettore MED/07 - Microbiologia E Microbiologia ClinicaHepatitis B virusHBsAgCD52Antibodies Neoplasmmedicine.medical_treatmenthepatitis B viruAntibodies Monoclonal Humanizedmedicine.disease_causeCampath-1HSettore MED/15 - Malattie Del SanguemedicineHumansAlemtuzumabImmunosuppression TherapyHepatitisHepatitis B virusSettore MED/12 - GastroenterologiaHepatitis B Surface Antigensbusiness.industryacute hepatitiAntibodies Monoclonalvirus diseasesLamivudineImmunosuppressionHematologyGeneral MedicineMiddle AgedHepatitis BHepatitis Bmedicine.diseaseLeukemia Lymphocytic Chronic B-Celldigestive system diseasesLamivudineDNA ViralImmunologyReverse Transcriptase InhibitorsAlemtuzumabFemaleVirus Activationbusinesschronic lymphocytic leukaemiamedicine.drugdescription
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. Immmunotherapy 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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2005-03-01 | European Journal of Haematology |