Fulminant hepatitis B and acute hepatitis B due to intrafamilial transmission of HBV after chemotherapy for non-Hodgkin's lymphoma in an HBV carrier

被引:14
作者
Aomatsu, Tomoki [2 ]
Komatsu, Haruki [1 ,3 ]
Yoden, Atsushi [2 ]
Hosomi, Akiko [4 ]
Miyazaki, Hiroshi [2 ]
Sogo, Tsuyoshi [3 ]
Inui, Ayano [3 ]
Fujisawa, Tomoo [3 ]
Tamai, Hiroshi [2 ]
机构
[1] Yokohama Eastern Hosp, Childrens Ctr Hlth & Dev, Kanagawa, Japan
[2] Osaka Med Coll, Dept Pediat, Takatsuki, Osaka 569, Japan
[3] Yokohama Eastern Hosp, Dept Pediat, Yokohama, Kanagawa, Japan
[4] Saiseikai Suita Hosp, Dept Pediat, Suita, Osaka, Japan
关键词
Hepatitis B virus; Horizontal transmission; Fulminant hepatitis; Chemotherapy; Reactivation; VIRUS REACTIVATION; CYTOTOXIC CHEMOTHERAPY; JAPAN; LAMIVUDINE; INFECTION; MUTATIONS; RITUXIMAB; GENOTYPES; PATIENT; RISK;
D O I
10.1007/s00431-009-1000-6
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Hepatitis B virus (HBV) reactivation after chemotherapy has been investigated, but little is known about the risk of horizontal transmission from an immunocompromised host with HBV reactivation. We treated two children with fulminant hepatitis B and acute hepatitis B, respectively, whose grandmother, an HBV carrier, had been undergoing rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R+CHOP) therapy for lymphoma. The grandmother was also suffering from fulminant hepatitis when both children became ill. The complete HBV DNA sequences of the three family members were identical. The full genome sequence analysis of HBV provided strong evidence of intrafamilial transmission of HBV. Treatments that cause immunosuppression, such as R+CHOP therapy for lymphoma, can increase the levels of serum HBV DNA and the risk of intrafamilial HBV infection when given to HBV carriers. In conclusion, specific antiviral prophylaxis is indispensable for preventing horizontal transmission as well as reactivation of HBV in chemotherapy-treated HBV carriers.
引用
收藏
页码:167 / 171
页数:5
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