HBsAb/HBeAb/HBcAb阳性多发性骨髓瘤化疗后HBV再激活1例并文献复习  

A case report and literature review of HBV reactivation after multiple myeloma chemotherapy in HBsAb/HBeAb/HBcAb-positive patients

作　　者：张春兰 陈茂伟 ZHANG Chunlan;CHEN Maowei(Department of Infectious Diseases,Wuming Hospital Affiliated to Guangxi Medical University,Wuming530199,China)

机构地区：[1]广西医科大学附属武鸣医院感染科,广西武鸣530199

出　　处：《中国现代医生》2020年第21期164-166,共3页China Modern Doctor

摘　　要：乙肝再激活通常发生在慢性乙型病毒性肝炎感染患者在接受肿瘤化疗或免疫治疗过程中,但发生抗-HBs阳性患者中少见。本文报道1例65岁HBsAb阳性男性患者因诊断“多发性骨髓瘤”长期接受(硼替佐米/阿霉素/地塞米松/雷纳度胺)化疗,既往无肝病病史,化疗前及化疗期间多次查HBV血清标志物提示HBsAg、HBeAg均阴性,HBsAb、HBeAb、HBcAb均阳性,化疗6周期后出现乙肝再激活,HBVDNA回报为2.46×106 IU/mL,经护肝、退黄、修复受损肝细胞、人工肝血浆置换等内科综合治疗病情好转出院。Hepatitis B reactivation usually occurs in patients with chronic hepatitis B infection during tumor chemotherapy or immunotherapy.But it is rare in anti-HBs positive patients.This article reports that a 65-year-old HBsAb-positive male patient received long-term chemotherapy(bortizomil/adriamycin/dexamethasone/renalidomide)for the diagnosis of"multiple myeloma",with no previous history of liver disease.Multiple examinations of HBV serum markers indicated that HBsAg and HBeAg were negative,and HBsAb,HBeAb,and HBcAb were positive before and during chemotherapy.Hepatitis B reactivation occurred after 6 cycles of chemotherapy.The HBV DNA was 2.46×106 IU/mL.The patient was discharged from the hospital after comprehensive medical treatment such as liver protection,retreat yellow,repair of damaged hepatocytes,and artificial liver plasma replacement.

关 键 词：抗-HBS阳性 乙肝再激活 多发性骨髓瘤 免疫抑制药物 

分 类 号：R446.6[医药卫生—诊断学]