Fatal Reactivation of Occult Hepatitis B Virus Infection after Rituximab and Chemotherapy in Lymphoma: Necessity of Antiviral Prophylaxis

The anti-CD20 monoclonal antibody rituximab has been used extensively in the treatment of B-cell lymphoma. However, several studies reported hepatitis B virus (HBV) reactivation after rituximab administration. The majority of these cases have been described in chronic carriers of HBV, whereas reactivation in occult hepatitis B carriers is relatively rare. We report a fatal case of fulminant hepatitis B that occurred in a B-cell lymphoma patient with occult hepatitis B after rituximab-containing chemotherapy, which raised the necessity of antiviral prophylaxis in this setting.