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A 62-year-old Japanese man who was positive for hepatitisB surface antigen(HBsAg)and anti-HBe antibody,underwentchemotherapy for non-Hodgkin’s lymphoma(NHL).Mutationswere detected in the precore region(nt1896)of HBV.Because steroid-containing regimen may cause reactivationof hepatitis B virus(HBV)and hepatitis may progress to befulminant after its withdrawal,we administered CHO(CPA,DOX and VCR)therapy and the patient obtained completeresponse.However,he developed acute exacerbation ofhepatitis due to HBV reactivation.Recovery was achievedwith lamivudine(100 mg/d)and plasma exchange.Thepresent case suggests that acute exacerbation of hepatitiscan occur with steroid-free regimen.Because the efficacyof the prophylactic use of lamivudine has been reportedand the steroid enhances curability of malignant lymphoma,the steroid containing regimen with prophylaxis oflamivudine should be evaluated further.
A 62-year-old Japanese man who was positive for hepatitis B surface antigen (HBsAg) and anti-HBe antibody, underwent chemotherapy for non-Hodgkin’s lymphoma (NHL). Mutations were detected in the precore region (nt 1896) of HBV.Because steroid-containing regimen may cause reactivation of hepatitis B virus (HBV) and hepatitis may progress to be fulminant after its withdrawal, we administered CHO (CPA, DOX and VCR) therapy and the patient obtained completeresponse.However, he developed acute exacerbation of hepatopathy due to HBV reactivation. Recovery was achieved with lamivudine (100 mg / d) and plasma exchange. The present case suggests that acute exacerbation of hepatitis can occur with steroid-free regimen. Of the efficacy of the prophylactic use of lamivudine has been reported and the steroid enhances curability of malignant lymphoma, the steroid containing regimen with prophylaxis oflamivudine should be evaluated further.