Journal
JOURNAL OF INFECTION
Volume 65, Issue 2, Pages 180-183Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2011.11.021
Keywords
HBV reactivation; Rituximab; Occult HBV; Anti-core negativity
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We describe a case of an anti-HBs-positive patient who experienced hepatitis B reactivation 18 months after the discontinuation of rituximab and after 12 months of lamivudine prophylaxis. The patient carried a hepatitis B genotype D virus harbouring a single immune escape mutation, sT118K. No consensus guidelines regarding the optimal length of treatment or the best elective drug have been defined for antiviral prophylaxis for HBsAg-negative, anti-HBc- and/or anti-HBs-positive patients undergoing immunosuppressive treatment. Screening based on HBV serological markers and HBV DNA testing is a critical issue to recognise hepatitis B reactivation as early as possible. Furthermore, it is of outstanding importance to identify alternative markers (e.g. cccDNA, HBV core related antigen, etc.), that could be predictive of HBV reactivation. (C) 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
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