CAJ | 학술논문

目的探讨长期服用伊马替尼触发乙型肝炎病毒(HBV)再激活的可能原因及其可能的监控管理措施.方法报道2例服用伊马替尼过程中出现HBV再激活的慢性髓性白血病(CML)患者,并针对发生机制、治疗预防相关措施进行文献复习.结果 2例HBsAg阳性、肝功能正常的CML患者,在服用伊马替尼过程中出现一过性的HBV再激活.经过抗病毒药物和伊马替尼联合治疗,最终获得良好转归.结论对于长期服用伊马替尼是否会导致病毒再激活问题上仍存在众多争议,鉴于已有相关病例报道,建议所有CML患者在伊马替尼治疗前,均进行HBV血清学筛查.只要HBsAg阳性,就应该预防性抗病毒治疗,并监测血清学、病毒学和生化指标.
목적 탐토장기복용이마체니촉발을형간염병독(HBV)재격활적가능원인급기가능적감공관리조시.방법 보도2례복용이마체니과정중출현HBV재격활적만성수성백혈병(CML)환자,병침대발생궤제、치료예방상관조시진행문헌복습.결과 2례HBsAg양성、간공능정상적CML환자,재복용이마체니과정중출현일과성적HBV재격활.경과항병독약물화이마체니연합치료,최종획득량호전귀.결론 대우장기복용이마체니시부회도치병독재격활문제상잉존재음다쟁의,감우이유상관병례보도,건의소유CML환자재이마체니치료전,균진행HBV혈청학사사.지요HBsAg양성,취응해예방성항병독치료,병감측혈청학、병독학화생화지표.
Objective To probe the cause for triggering HBV reactivation and possible management of the chmnic hepatitis B individuals received imatinib.Methods This study presented two cases of transient hepatitis B vims(HBV) reactivation and hepatic dysfunction during oral imatinib for chronic myeloid leukemia (CML) and made a literatures review about the pathogenesis,possible prophylactic and therapeutic management of such chronic hepatitis B individuals receiving imatinib.Results Two CML patients,without prior liver dysfunction but with chronic HBV infection.suffered from transient HBV reactivation occurred during oral imatinib.Both of them finally obtained good outcome following the additional oral nucleotide antiviral therapy.Conclusion It remained unclear whether imatinib induced the reactivation of HBV in patients with a latent HBV infection.From our study.all candidates receiving oral imatinib should be screened for HBsAg and anti-HBc antibodies Drior to initiation of imatinib.Prophylactic antiviral therapy should be offered to HBV-infected individualS along with a close monitoring for signs of reactivation.