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Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy

BACKGROUND: Ibrutinib is a Bruton’s tyrosine kinase (BTK) inhibitor approved for the treatment for several mature B-cell malignancies. Reactivation of hepatitis B virus (HBV) is a well-described complication in patients with chronic HBV infection or prior HBV exposure undergoing cytotoxic or immunos...

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Autores principales: Lam, Lok-Ka, Chan, Thomas Sau Yan, Hwang, Yu-Yan, Mak, Lung-Yi, Seto, Wai-Kay, Kwong, Yok-Lam, Yuen, Man-Fung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10394758/
https://www.ncbi.nlm.nih.gov/pubmed/37528444
http://dx.doi.org/10.1186/s12985-023-02140-w
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author Lam, Lok-Ka
Chan, Thomas Sau Yan
Hwang, Yu-Yan
Mak, Lung-Yi
Seto, Wai-Kay
Kwong, Yok-Lam
Yuen, Man-Fung
author_facet Lam, Lok-Ka
Chan, Thomas Sau Yan
Hwang, Yu-Yan
Mak, Lung-Yi
Seto, Wai-Kay
Kwong, Yok-Lam
Yuen, Man-Fung
author_sort Lam, Lok-Ka
collection PubMed
description BACKGROUND: Ibrutinib is a Bruton’s tyrosine kinase (BTK) inhibitor approved for the treatment for several mature B-cell malignancies. Reactivation of hepatitis B virus (HBV) is a well-described complication in patients with chronic HBV infection or prior HBV exposure undergoing cytotoxic or immunosuppressive chemotherapy for hematologic malignancies. This phenomenon has been frequently reported with rituximab. However, published data on the risk of HBV reactivation induced by ibrutinib are scarce. Cases of HBV reactivation in hematologic patients receiving ibrutinib therapy have recently been described, but limited only to overt hepatitis B patients or seropositive occult hepatitis B patients. CASE PRESENTATION: We report the first case of HBV reactivation during ibrutinib treatment in an asymptomatic 82-year-old woman with seronegative occult hepatitis B patient (i.e., negative for HBsAg, anti-HBc and anti-HBs). Four months after ibrutinib treatment, her liver function test (LFT) was deranged, with seroconversion to HBsAg positivity. Serum hepatitis B virus DNA was quantified to be 1.92 × 10(8) IU/ml. Antiviral treatment was initiated, and viral load was gradually suppressed with improvement in LFT. CONCLUSIONS: Our case illustrated that in populations with a high incidence of HBV exposure, systematic screening for HBV exposure is essential prior to ibrutinib treatment, followed by serial monitoring of serologic and molecular markers of hepatitis B. There is a need for an international consensus to support the recommendation of antiviral prophylaxis against HBV reactivation in patients using ibrutinib.
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spelling pubmed-103947582023-08-03 Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy Lam, Lok-Ka Chan, Thomas Sau Yan Hwang, Yu-Yan Mak, Lung-Yi Seto, Wai-Kay Kwong, Yok-Lam Yuen, Man-Fung Virol J Case Report BACKGROUND: Ibrutinib is a Bruton’s tyrosine kinase (BTK) inhibitor approved for the treatment for several mature B-cell malignancies. Reactivation of hepatitis B virus (HBV) is a well-described complication in patients with chronic HBV infection or prior HBV exposure undergoing cytotoxic or immunosuppressive chemotherapy for hematologic malignancies. This phenomenon has been frequently reported with rituximab. However, published data on the risk of HBV reactivation induced by ibrutinib are scarce. Cases of HBV reactivation in hematologic patients receiving ibrutinib therapy have recently been described, but limited only to overt hepatitis B patients or seropositive occult hepatitis B patients. CASE PRESENTATION: We report the first case of HBV reactivation during ibrutinib treatment in an asymptomatic 82-year-old woman with seronegative occult hepatitis B patient (i.e., negative for HBsAg, anti-HBc and anti-HBs). Four months after ibrutinib treatment, her liver function test (LFT) was deranged, with seroconversion to HBsAg positivity. Serum hepatitis B virus DNA was quantified to be 1.92 × 10(8) IU/ml. Antiviral treatment was initiated, and viral load was gradually suppressed with improvement in LFT. CONCLUSIONS: Our case illustrated that in populations with a high incidence of HBV exposure, systematic screening for HBV exposure is essential prior to ibrutinib treatment, followed by serial monitoring of serologic and molecular markers of hepatitis B. There is a need for an international consensus to support the recommendation of antiviral prophylaxis against HBV reactivation in patients using ibrutinib. BioMed Central 2023-08-01 /pmc/articles/PMC10394758/ /pubmed/37528444 http://dx.doi.org/10.1186/s12985-023-02140-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Lam, Lok-Ka
Chan, Thomas Sau Yan
Hwang, Yu-Yan
Mak, Lung-Yi
Seto, Wai-Kay
Kwong, Yok-Lam
Yuen, Man-Fung
Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy
title Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy
title_full Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy
title_fullStr Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy
title_full_unstemmed Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy
title_short Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy
title_sort hepatitis b virus reactivation in seronegative occult hepatitis b patient receiving ibrutinib therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10394758/
https://www.ncbi.nlm.nih.gov/pubmed/37528444
http://dx.doi.org/10.1186/s12985-023-02140-w
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