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World J Hepatol. Nov 27, 2013; 5(11): 612-620
Published online Nov 27, 2013. doi: 10.4254/wjh.v5.i11.612
Hepatitis B virus reactivation with rituximab-containing regimen
Yutaka Tsutsumi, Yoshiya Yamamoto, Joji Shimono, Hiroyuki Ohhigashi, Takanori Teshima
Yutaka Tsutsumi, Joji Shimono, Hiroyuki Ohhigashi, Department of Hematology, Hakodate Municipal Hospital, Minato-cho, Hakodate 041-8680, Japan
Yoshiya Yamamoto, Department of Gastroenterology, Hakodate Municipal Hospital, Minato-cho, Hakodate 041-8680, Japan
Takanori Teshima, Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo JIS-01663, Japan
Author contributions: All authors contributed equally to this report.
Correspondence to: Yutaka Tsutsumi, MD, PhD, Department of Hematology, Hakodate Municipal Hospital, Hakodate 1-10-1, Minato-cho, Hakodate 041-8680, Japan. yutsutsu@shore.ocn.ne.jp
Telephone: +81-138-432000 Fax: +81-138-434426
Received: September 6, 2013
Revised: October 21, 2013
Accepted: November 2, 2013
Published online: November 27, 2013
Processing time: 80 Days and 22.6 Hours
Abstract

Rituximab is recognized as a useful drug for the treatment of B-cell non-Hodgkin’s lymphoma and its use has been extended to such diseases as idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, chronic rheumatoid arthritis and ANCA-associated vasculitides. One serious complication associated with its use is the reactivation of hepatitis B virus and the search for methods to prevent this occurrence has resulted in the rapid accumulation of knowledge. In this review, we discuss case analyses from our department and other groups and outline the current knowledge on the topic and the remaining issues.

Keywords: Rituximab; Hepatitis B virus; Reactivation; Chemotherapy; Lamivudine; Non-Hodgkin's lymphoma

Core tip: The deleterious effects of hepatitis B virus (HBV) reactivation in rituximab-containing chemotherapy regimens have been reported and the effect of lamivudine treatment in the prevention of HBV reactivation is also well documented. Once reactivated, HBV may lead to death due to hepatitis. In this review, we discuss the factors of preventive lamivudine treatment (especially in the course of HBV antibody), including to whom and for how long the drug should be given, based on case studies and reports that span rituximab’s debut in 2002 on the Japanese market to June 2013.