骨髄移植後にHBVキャリア状態となり, 経過中にステロイド離脱現象様の急性憎悪を認めHBs抗原のseroconversionとの肝機能の改善を認めた1症例

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A 35-year-old man with acute non-lymphoblastic leukemia, underwent bone marrow transplantation (BMT) and then developed the HBV carrier state. His HBV infection was thought to originate from multiple blood transfusions received in the course of BMT therapy. After BMT, instead of recovery of the lymphocyte count in the peripheral blood, the T4/T8 ratio remained low. Predonisolone was given for the prevention of graft versus host disease. During the tapering off of predonisolone treatment, liver function abnormalities were temporarily exacerbated, and then gradually improved. Finally HBsAg became undetectable. This suggests the possibility of the effectiveness of anti-viral therapy following development of the HBV carrier state, in a patient who underwent BMT and had decreased T cell funciton, if treatment is initiated as early as possible.
社団法人日本肝臓学会の論文