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Reactivation of hepatitis B two years after rituximab therapy in a renal transplant patient with recurrent focal segmental glomerulosclerosis: a note of caution
Author(s) -
Gossmann Jan,
Scheuermann ErnstHeinrich,
Kachel HeinzGeorg,
Geiger Helmut,
Hauser Ingeborg A.
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2008.00936.x
Subject(s) - medicine , rituximab , focal segmental glomerulosclerosis , hepatitis b , hepatitis b virus , lamivudine , immunology , hepatitis , antibody , gastroenterology , virology , nephrotic syndrome , glomerulonephritis , kidney , virus
We report on the reactivation of hepatitis B in a renal transplant patient who had been treated with rituximab for recurrent focal segmental glomerulosclerosis two and a half yr previously. He lost his anti‐hepatitis B surface antigens and anti‐hepatitis B core antigen antibodies and developed hepatitis B virus (HBV)‐DNA positive hepatitis. Hepatitis C, which had been successfully treated by alpha interferon 10 yr before, remained quiescent. We suggest regular controls of HBV‐DNA, anti‐HBV antibodies and transaminases for prolonged periods in patients with status post‐hepatitis B treated with rituximab. Prophylactic therapy with lamivudine and/or hepatitis B hyperimmune globulin may be considered in patients with a decrease in anti‐HBV antibodies.