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Lam LK, Chan TSY, Hwang YY, Mak LY, Seto WK, Kwong YL, Yuen MF. Hepatitis B virus reactivation in seronegative occult hepatitis B patient receiving ibrutinib therapy. Virol J 2023; 20:168. [PMID: 37528444 PMCID: PMC10394758 DOI: 10.1186/s12985-023-02140-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023] Open
Abstract
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 × 108 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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Affiliation(s)
- Lok-Ka Lam
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hongkong
| | - Thomas Sau Yan Chan
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hongkong
| | - Yu-Yan Hwang
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hongkong
| | - Lung-Yi Mak
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hongkong
- State Key Laboratory of Liver Research, The University of Hong Kong, Pokfulam, Hongkong
| | - Wai-Kay Seto
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hongkong
- State Key Laboratory of Liver Research, The University of Hong Kong, Pokfulam, Hongkong
| | - Yok-Lam Kwong
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hongkong
| | - Man-Fung Yuen
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hongkong.
- State Key Laboratory of Liver Research, The University of Hong Kong, Pokfulam, Hongkong.
- Queen Mary Hospital, Professorial Block, 102, Pokfulam Road, Hong Kong.
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Innocenti I, Reda G, Visentin A, Coscia M, Motta M, Murru R, Moia R, Gentile M, Pennese E, Quaglia FM, Albano F, Cassin R, Deodato M, Ielo C, Frustaci AM, Piciocchi A, Rughini A, Arena V, Di Sevo D, Tomasso A, Autore F, Del Poeta G, Scarfò L, Mauro FR, Tedeschi A, Trentin L, Pompili M, Foà R, Ghia P, Cuneo A, Laurenti L. Risk of hepatitis B virus reactivation in chronic lymphocytic leukemia patients receiving ibrutinib with or without antiviral prophylaxis. A retrospective multicentric GIMEMA study. Haematologica 2022; 107:1470-1473. [PMID: 35199505 PMCID: PMC9152973 DOI: 10.3324/haematol.2021.280325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/11/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Idanna Innocenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma
| | - Gianluigi Reda
- U.O.C. Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | - Andrea Visentin
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova
| | - Marta Coscia
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, Torino
| | | | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale A. Businco, ARNAS "G.Brotzu", Cagliari
| | - Riccardo Moia
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara
| | - Massimo Gentile
- UOC Ematologia AO di Cosenza, Presidio Ospedaliero Annunziata, Cosenza
| | - Elsa Pennese
- U.O.S.D. Centro Diagnosi e Terapia dei Linfomi, Dipartimento Oncologico-Ematologico, Presidio Ospedaliero "Spirito Santo", Pescara
| | | | - Francesco Albano
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari "Aldo Moro", Bari
| | - Ramona Cassin
- U.O.C. Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | - Marina Deodato
- ASST Grande Ospedale Metropolitano Niguarda Hospital, Milano
| | - Claudia Ielo
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Roma
| | | | | | | | | | | | - Annamaria Tomasso
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma
| | - Francesco Autore
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma
| | - Giovanni Del Poeta
- UOC Unit of Hematology and Stem Cell Transplantation, AOU Policlinico Tor Vergata Roma, Roma
| | - Lydia Scarfò
- Strategic Research Program on CLL, Università Vita Salute and IRCSS Ospedale San Raffaele, Milano
| | - Francesca Romana Mauro
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Roma
| | | | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova
| | - Maurizio Pompili
- Dipartimento di Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Roma
| | - Paolo Ghia
- Strategic Research Program on CLL, Università Vita Salute and IRCSS Ospedale San Raffaele, Milano
| | - Antonio Cuneo
- Hematology section, Department of Medical Sciences, University of Ferrara, Ferrara
| | - Luca Laurenti
- Sezione di Ematologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Roma.
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