DOI QR코드

DOI QR Code

Hepatitis B Virus Reactivation after Partial Hepatic Irradiation Alone: A Case Report

부분 간조사만을 시행받은 환자에서의 B형 간염바이러스의 재활성화: 증례보고

  • Kim, Bo-Kyong (Department of Radiation Oncology, Dankook University College of Medicine)
  • 김보경 (단국대학교 의과대학 방사선종양학교실)
  • Received : 2010.04.07
  • Accepted : 2010.04.29
  • Published : 2010.06.30

Abstract

Reactivation of the hepatitis B virus (HBV) is a well-recognized complication in patients with chronic HBV infection who receive cytotoxic or other immunosuppressive therapy. In cases of patients treated by radiotherapy however, only a few of such reports exist and most of these include the patients previously treated by chemotherapy or transarterial chemoembolization. The results of this study point to a case of a patient with reactivation of HBV after radiotherapy alone. This study shows the possibility of HBV reactivation by partial hepatic irradiation alone hence, special attention should be paid to patients with HBV disease.

B형 간염바이러스의 재활성화는 세포독성치료 및 면역억제치료를 시행 받은 만성 B형 간염 환자 및 보균자들에서 잘 알려진 합병증이다. 방사선치료의 경우, B형 간염바이러스 재활성화에 대한 연구는 그 수가 적으며, 대개 이전에 항암화학요법 또는 경동맥화학색전술을 시행 받은 환자를 포함한다. 간의 방사선조사만을 시행 받은 환자에서의 B형 간염바이러스의 재활성화에 대한 연구는 보고된 바 없으며, 이에 본 증례를 보고한다. 본 연구를 통하여, 간의 국소방사선조사 단독으로 B형 간염바이러스의 재활성화 유발의 가능성을 확인하였으며, 따라서, 간을 포함한 방사선조사 시 B형 간염관련 간질환 환자의 경우 방사선 관련 간질환뿐 아니라 바이러스의 재활성화에 대한 고려도 요구된다.

Keywords

References

  1. Lok AS, Liang RH, Chiu EK, Wong KL, Chan TK, Todd D. Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy: report of a prospective study. Gastroenterology 1991;100:182-188
  2. Yeo W, Chan PK, Zhong S, et al. Frequency of hepatitis B virus reactivation in cancer patients undergoing cytotoxic chemotherapy: a prospective study of 626 patients with identification of risk factors. J Med Virol 2000;62:299-307 https://doi.org/10.1002/1096-9071(200011)62:3<299::AID-JMV1>3.0.CO;2-0
  3. Liao CA, Lee CM, Wu HC, Wang MC, Lu SN, Eng HL. Lamivudine for the treatment of hepatitis B virus reactivation following chemotherapy for non-Hodgkin's lymphoma. Br J Haematol 2002;116:166-169 https://doi.org/10.1046/j.1365-2141.2002.03239.x
  4. Sharma SK, Saini N, Chwla Y. Hepatitis B virus: inactive carriers. Virol J 2005;2:82 https://doi.org/10.1186/1743-422X-2-82
  5. Kim JH, Park JW, Kim TH, Koh DW, Lee WJ, Kim CM. Hepatitis B virus reactivation after three-dimensional conformal radiotherapy in patients with hepatitis B virus-related hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 2007;69: 813-819 https://doi.org/10.1016/j.ijrobp.2007.04.005
  6. Cheng JC, Wu JK, Lee PC, et al. Biologic susceptibility of hepatocellular carcinoma patients treated with radiotherapy to radiation-induced liver disease. Int J Radiat Oncol Biol Phys 2004;60:1502-1509 https://doi.org/10.1016/j.ijrobp.2004.05.048
  7. Maddrey WC. Hepatitis B: an important public health issue. J Med Virol 2000;61:362-366 https://doi.org/10.1002/1096-9071(200007)61:3<362::AID-JMV14>3.0.CO;2-I
  8. Lee WM. Hepatitis B virus infection. N Engl J Med 1997;337:1733-1745 https://doi.org/10.1056/NEJM199712113372406
  9. Cheng JC, Liu MC, Tsai SY, Fang WT, Jer-Min Jian J, Sung JL. Unexpectedly frequent hepatitis B reactivation by chemoradiation in postgastrectomy patients. Cancer 2004;101: 2126-2133 https://doi.org/10.1002/cncr.20591
  10. Reed GB Jr, Cox AJ Jr. The human liver after radiation injury: a form of veno-occlusive disease. Am J Pathol 1966; 48:597-611
  11. Lawrence TS, Robertson JM, Anscher MS, Jirtle RL, Ensminger WD, Fajardo LF. Hepatic toxicity resulting from cancer treatment. Int J Radiat Oncol Biol Phys 1995;31: 1237-1248 https://doi.org/10.1016/0360-3016(94)00418-K
  12. Yamasaki SA, Marn CS, Francis IR, Robertson JM, Lawrence TS. High-dose localized radiation therapy for treatment of hepatic malignant tumors: CT findings and their relation to radiation hepatitis. AJR Am J Roentgenol 1995;165: 79-84 https://doi.org/10.2214/ajr.165.1.7785638
  13. Herfarth KK, Hof H, Bahner mL, et al. Assessment of focal liver reaction by multiphasic CT after stereotactic singledose radiotherapy of liver tumors. Int J Radiat Oncol Biol Phys 2003;57:444-451 https://doi.org/10.1016/S0360-3016(03)00586-8
  14. Chou CH, Chen PJ, Lee PH, Cheng AL, Hsu HC, Cheng JC. Radiation-induced hepatitis B virus reactivation in liver mediated by the bystander effect from irradiated endothelial cells. Clin Cancer Res 2007;13:851-857 https://doi.org/10.1158/1078-0432.CCR-06-2459
  15. Chou CH, Chen PJ, Jeng YM, Cheng AL, Huang LR, Cheng JC. Synergistic effect of radiation and interleukin-6 on hepatitis B virus reactivation in liver through STAT3 signaling pathway. Int J Radiat Oncol Biol Phys 2009;75:1545-1552 https://doi.org/10.1016/j.ijrobp.2008.12.072