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Case report: Recombinant human type II tumour necrosis factor receptor-antibody fusion protein induced occult hepatitis B virus reactivation leading to liver failure

Authors :
Yujie Qin
Wenxiu Zhou
Xingnian Zhou
Hong Li
Source :
Journal of International Medical Research, Vol 52 (2024)
Publication Year :
2024
Publisher :
SAGE Publishing, 2024.

Abstract

Recombinant human type II tumour necrosis factor receptor-antibody fusion protein (rh TNFR:Fc) is an immunosuppressant approved for treating rheumatoid arthritis (RA). This case report describes a case of hepatitis B reactivation in a patient with drug-induced acute-on-chronic liver failure. A 58-year-old woman with a history of RA was treated with rh TNFR:Fc; and then subsequently received 25 mg rh TNFR:Fc, twice a week, as maintenance therapy. No anti-hepatitis B virus (HBV) preventive treatment was administered. Six months later, she was hospitalized with acute jaundice. HBV reactivation was observed, leading to acute-on-chronic liver failure. After active treatment, the patient’s condition improved and she recovered well. Following careful diagnosis and treatment protocols are essential when treating RA with rh TNFR:Fc, especially in anti-hepatitis B core antigen antibody-positive patients, even when the HBV surface antigen and the HBV DNA are negative. In the case of HBV reactivation, liver function parameters, HBV surface antigen and HBV DNA should be closely monitored during treatment, and antiviral drugs should be used prophylactically when necessary, as fatal hepatitis B reactivation may occur in rare cases. A comprehensive evaluation and medication should be administered in a timely manner after evaluating the patient’s physical condition and closely monitoring the patient.

Subjects

Subjects :
Medicine (General)
R5-920

Details

Language :
English
ISSN :
14732300 and 03000605
Volume :
52
Database :
Directory of Open Access Journals
Journal :
Journal of International Medical Research
Publication Type :
Academic Journal
Accession number :
edsdoj.064228ef07942d089e4f29b526b7693
Document Type :
article
Full Text :
https://doi.org/10.1177/03000605241252580