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Hepatitis B virus reactivation during combined therapy with deferiprone and desferioxamine in a hepatitis B surface antigen thalassemic carrier

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Abstract

In this report we firstly describe a case of reactivation of hepatitis B virus (HBV) replication occurred in a patient affected by Thalassemia major which underwent a combined chelation therapy with desferioxamine (DFO) and deferiprone (DFP). Clinical symptom and increase in alanine aminotransferase (ALT) level were detected when the prescription of DFO (30 mg/kg) was increased from 3 to 5 days/week; a raise in HBV-DNA levels of greater than or equal to tenfold compared with baseline was thereafter detected. Diagnosis was troublesome because increasing ALT levels, first suggested toxicity to DFP administration. However, HBV reactivation in our patient cannot be definitively attributed to combined regimen administration: the patient was on regular transfusion therapy and either coincidental further infection or spontaneous reactivation of HBV could not be completely ruled out. Furthermore, a background of immunologic abnormalities had been previously reported in thalassemia and postulated to be secondary to iron overload or DFO therapy itself.

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Authors and Affiliations

  1. Unità Operativa Complessa, Centro delle Microcitemie “A. Mastrobuoni”, AORN A. Cardarelli, Naples, Italy

    Paolo Ricchi, Patrizia Cinque, Massimiliano Ammirabile & Luciano Prossomariti

  2. Unità Operativa Complessa di Epatologia, AORN A. Cardarelli, Naples, Italy

    Alfonso Lanza Galeota

  3. Centro Traumatologico Ortopedico ASLNA1, Naples, Italy

    Tiziana Di Matola

  4. UOC Microcitemia, Azienda Ospedaliera di Rilievo Nazionale “A. Cardarelli”, Via A.Cardarelli 9, 80131, Naples, Italy

    Paolo Ricchi

Authors
  1. Paolo Ricchi
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  2. Patrizia Cinque
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  3. Alfonso Lanza Galeota
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  4. Tiziana Di Matola
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  5. Massimiliano Ammirabile
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  6. Luciano Prossomariti
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Correspondence to Paolo Ricchi.

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Ricchi, P., Cinque, P., Lanza Galeota, A. et al. Hepatitis B virus reactivation during combined therapy with deferiprone and desferioxamine in a hepatitis B surface antigen thalassemic carrier. Int J Hematol 89, 135–138 (2009). https://doi.org/10.1007/s12185-008-0229-6

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  • DOI: https://doi.org/10.1007/s12185-008-0229-6

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