학술논문

Hepatitis B virus reactivation during belatacept treatment after kidney transplantation.
Document Type
Article
Source
Transplant Infectious Disease. Dec2019, Vol. 21 Issue 6, pN.PAG-N.PAG. 1p.
Subject
*KIDNEY transplantation
*HEPATITIS B virus
*BK virus
*LYMPHOCYTE count
*LIVER function tests
*HIV
Language
ISSN
1398-2273
Abstract
We report a case of HBV reactivation following belatacept treatment in a patient who underwent kidney transplantation in 2015 for HIV‐associated nephropathy (HIVAN). Human immunodeficiency virus viral load was undetectable prior to transplantation, and CD4+ lymphocyte count was greater than 300/mL. Baseline HBV serology at transplantation was HBsAg negative, anti‐HBcAb positive, anti‐HBsAb 312 UI/L, and HBeAg negative/anti‐HBeAb positive. Liver function tests were normal, and viral DNA was undetectable. Two years later, the patient presented with severe acute hepatitis after a progressive disappearance of anti‐HbsAb, quickly followed by HBV reactivation. Immunosuppressive treatment was drastically reduced, and treatment with entecavir was started. The outcome was favorable, and HBV DNA became undetectable after 9 weeks of treatment. This is the first report of acute hepatitis related to HBV reactivation in a kidney transplant recipient treated with belatacept. The risk for HBV reactivation in patients treated with belatacept should not be underestimated, especially in those with resolved HBV infection. [ABSTRACT FROM AUTHOR]