Association of Chronic HBV Infection with Chronic Lymphoproliferative Disorders: A Review and Case Report

Snezhana S. Sleptsova, PhD, ScD¹; Vera N. Yadrichinskaya, PhD¹; Aida M. Palchina, PhD¹; Nataliya V. Borisova, PhD, ScD¹; Inna M. Mulina²; Svetlana N. Parfenova²; Lev S. Butaev¹; Lyubov D. Indeeva, PhD³

¹North-Eastern Federal University named after M.K. Ammosov, Yakutsk; ²Republican Hospital №1, National Center of Medicine, Yakutsk; ³Yakutsk city clinical hospital; the Republic of Sakha (Yakutia), Russia

Corresponding author:  Nataliya V. Borisova, PhD, ScD. North-Eastern Federal University named after M.K. Ammosov, Yakutsk, the Republic of Sakha (Yakutia), Russia  E-mail:

Published: June 20, 2016.  DOI: 10.21103/Article6(2)_CRep1


This article presents a clinical report on the associated course of chronic hepatitis B virus (HBV) infection with Castleman's disease (CD). We noticed the reactivation of previously latent chronic hepatitis B (CHB) with high replicative activity of HBV DNA during the treatment of lymphoproliferative disease. This clinical case dictates the need for pre-emptive therapy of HBV infection with nucleoside analogues in patients who are receiving chemotherapy.

chronic hepatitis B; Castleman's disease; chemotherapy; rituximab; reactivation of viral infextion.
  1. Ivashkin VT, Bueverov AO. Rational pharmacotherapy in hematology. M.: Litterra; 2009. [in Russian].
  2. Abdurakhmanov DT. Chronic hepatitis B and D. M.: GEOTAR-Media; 2010, 288pp. [in Russian].
  3. Sleptsova SS. Viral hepatitis in the Republic of Sakha (Yakutia). Abstract of ScD Thesis. St. Petersburg; 2013. [in Russian].
  4. Yeo W, Johnson PJ. Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy. Hepatology 2006; 43(2): 209–20.
  5. Marcus R, Imrie K, Belch A, Cunningham D, Flores E, Catalano J, et al. CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. Blood. 2005; 105(4):1417–23.
  6. Fanale MA, Younes A. Monoclonal antibodies in the treatment of non-Hodgkin’s lymphoma. Drugs. 2007; 67(3):333–50.
  7. Aries PM, Hellmich B, Voswinkel J, Both M, Nölle B, Holl-Ulrich K, et al. Lack of efficacy of rituximab in Wegener’s granulomatosis with refractory granulomatous manifestations. Ann Rheum Dis. 2006; 65(7): 853–8.
  8.  Stasi R, Pagano A, Stipa E, Amadori S. Rituximab chimeric anti-CD20 monoclonal antibody treatment for adults with chronic idiopathic thrombocytopenic purpura. Blood. 2001 Aug 15;98(4):952-7.
  9. Specks U, Fervenza FC, McDonald TJ, Hogan MC. Response of Wegener’s granulomatosis to anti-CD20 chimeric monoclonal antibody therapy. Arthritis Rheum. 2001; 44(12):2836–40.
  10. Ghielmini M, Schmitz SF, Cogliatti S, Bertoni F, Waltzer U, Fey MF, et al. Effect of single-agent rituximab given at the standard schedule or as prolonged treatment in patients with mantle cell lymphoma: a study of the Swiss Group for Clinical Cancer Research (SAKK). J Clin Oncol. 2005; 23(4):705–11.
  11. Lok AS, Ward JW, Perrillo RP, McMahon BJ, Liang TJ. Reactivation of Hepatitis B during immunosuppressive therapy: potentially fatal yet preventable. Ann Intern Med. 2012; 156(10): 743–5.
  12. Dervite I, Hober D, Morel P. Acute hepatitis B in a patient with antibodies to hepatitis B surface antigen who was receiving rituximab. N Engl J Med. 2001;344(1):68-9.
  13. Sera T, Hiasa Y, Michitaka K, Konishi I, Matsuura K, Tokumoto Y, et al. Anti-HBs-positive liver failure due to hepatitis B virus reactivation induced by rituximab. Intern Med. 2006;45(11):721-4.
  14. Law JK, Ho JK, Hoskins PJ, Erb SR, Steinbrecher UP, Yoshida EM. Fatal reactivation of hepatitis B post-chemotherapy for lymphoma in a hepatitis B surface antigen-negative, hepatitis B core antibody-positive patient: potential implications for future prophylaxis recommendations. Leuk Lymphoma. 2005; 46(7):1085–9.
  15. Yeo W, Chan TC, Leung NW, Lam WY, Mo FK, Chu MT, et al.Hepatitis B virus reactivation in lymphoma patients with prior resolved hepatitis B undergoing anticancer therapy with or without rituximab. J Clin Oncol. 2009; 27(4):605-11.
  16. Ikeda M. Reactivation of hepatitis B virus in patients receiving chemotherapy. Jpn J Clin Oncol. 2013; 43(1):8-16.
  17. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology 2007;45:507-39.
  18. Belongia EA, Costa J, Gareen IF, Grem JL, Inadomi JM, Kern ER, et al. NIH consensus development statement on management of hepatitis B. NIH Consens State Sci Statements. 2008 Oct 22-24;25(2):1-29.
  19. Hoofnagle JH. Reactivation of hepatitis B. Hepatology 2009;49(5 Suppl.):S156-65.
  20. European Association for the Study of the Liver. EASL clinical practice guidelines: management of chronic hepatitis B. J Hepatol 2009;50:227-42.
  21. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. 2009;50(3):661–2.
  22. Moses SE, Lim ZY, Sudhanva M, Devereux S, Ho AY, Pagliuca A,et al. Lamivudine prophylaxis andtreatment of hepatitis B virus-exposed recipients receiving reduced intensity conditioning hematopoietic stem cell transplants with alemtuzumab. J Med Virol. 2006; 78(12):1560–3. 
  23. Wong VW, Wong GL, Yiu KK, Chim AM, Chu SH, Chan HY, et al. Entecavir treatment in patients with severe acute exacerbation of chronic hepatitis B. J Hepatol. 2011; 54(2):236–42.
  24. Mastroianni CM, Lichtner M, Citton R, Del Borgo C, Rago A, Martini H, et al. Current trends in management of hepatitis B virus reactivation in the biologic therapy era. World J Gastroenterol. 2011;17(34):3881-7.
  25. Ono K, Iyama S, Matsunaga T, Sato T, Sato Y, Okuda T, et al. Reactivation of hepatitis B virus due to rituximab plus CHOP after preemptive lamivudine administration in a patient with diffuse large B-cell lymphoma. Gan To Kagaku Ryoho 2007; 34(9):1509–12. [Article in Japanese].
  26. Idilman R. Duration of lamivudine prophylaxis in in active hepatitis B virus carriers with haematooncological malignancies who receive chemotherapy. Gut (letter) 2006; 55: 1208–9.
  27. Castelman B, Towne VW. Case records of the Massachusetts General Hospital: Case No. 40231. N Engl J Med 1954; 250(23):1001-5.
  28. Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer 1972;29:670-683.
  29. Gaba AR, Stein RS, Sweet DL, Variakojis D. Multicentric giant lymph node hyperplasia. Am J Clin Pathol 1978;69:86-90
  30. Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, Moore PS. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi’s sarcoma. Science. 1994;266(5192):1865-9.
  31. Polizzotto MN, Uldrick TS, Wang V, Aleman K, Wyvill KM, Marshall V, et al. Human and viral interleukin-6 and other cytokines in Kaposi sarcoma herpesvirus-associated multicentric Castleman disease. Blood. 2013;122(26):4189-98.
  32. Yoshizaki K, Matsuda T, Nishimoto N, Kuritani T, Taeho L, Aozasa K, et al. Pathogenic significance of interleukin-6 (IL-6/BSF-2) in Castleman’s disease. Blood. 1989;74(4):1360-7.
  33. Soumerai JD, Sohani AR, Abramson JS. Diagnosis and management of Castleman disease. Cancer Control. 2014 Oct;21(4):266-78.
  34. van Rhee F, Stone K, Szmania S, Barlogie B, Singh Z. Castleman disease in the 21st century: an update on diagnosis, assessment, and therapy. Clin Adv Hematol Oncol 2010;8:486-498.
  35. Ivashkin BT, Yushchuk ND. Recommendations for the diagnosis and treatment of adult patients with hepatitis B and C. M.: GEOTAR-Media; 2015, 144pp. [in Russian].

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