Reactivation of chronic hepatitis B virus infection following rituximab administration for rheumatoid arthritis

Excerpt

In chronic hepatitis B virus infection, immune suppression has been linked with potential activation and, in a number of cases, acute liver failure and fatal outcome; patients with haematologic or other malignancies under chemotherapy were mostly affected [1]. In the same cohort of patients the incidence of HBV reactivation rose significantly in the past decade, after the introduction of rituximab, a monoclonal antibody targeted against the CD20(+) lymphocytes [2, 3]. In this setting, reactivation was recorded even in HBsAb(+) patients [4]. In patients with rheumatic diseases, analogous cases are still mainly anecdotal. Taking into account the increasing application of rituximab in the treatment of autoimmune diseases, and the global prevalence of chronic hepatitis B virus infection, cases of treatment-induced reactivation need to be recorded, in order to formulate prophylaxis and treatment guidelines, and to safely establish the safety profile of these agents in analogous circumstances [5]. …