Fulminant Hepatitis as a Consequence of Reactivation of Hepatitis B Virus Infection after Discontinuation of Low-Dose Methotrexate Therapy
Authors: Michele A. Flowers
Journal: Annals of Internal Medicine (1990)

Brief Reports1 March 1990Fulminant Hepatitis as a Consequence of Reactivation of Hepatitis B Virus Infection after Discontinuation of Low-Dose Methotrexate TherapyMichele A. Flowers, MD, Jenny Heathcote, MB, BS, MD, Ian R. Wanless, MD, Morris Sherman, MB, BCh, PhD, William J. Reynolds, MD, Ross G. Cameron, MD, PhD, Gary A. Levy, MD, Robert D. Inman, MDMichele A. Flowers, MD, Jenny Heathcote, MB, BS, MD, Ian R. Wanless, MD, Morris Sherman, MB, BCh, PhD, William J. Reynolds, MD, Ross G. Cameron, MD, PhD, Gary A. Levy, MD, Robert D. Inman, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-5-381 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDevelopment of liver disease in chronic hepatitis B virus carriers depends on the interplay between viral products and the host immune system. Although it is generally believed that the virus itself is not cytopathic, most clinical studies document viral replication when the liver disease is progressive. In contrast, chronic carriers of hepatitis B virus who have lost the markers of viral replication usually have static or only slowly progressive liver disease. Reactivation of viral replication in such patients is often associated with an increase in the activity of liver disease. Both spontaneous reactivation and reactivation in association with drug therapy...References1. Wands J, Chura C, Roll F, and Maddrey W. Serial studies of hepatitis-associated antigen and antibody in patients receiving antitumor chemotherapy for myeloproliferative and lymphoproliferative disorders. Gastroenterology. 1975;68:105-12. CrossrefMedlineGoogle Scholar2. Galbraith R, Eddleston A, Williams R, and Zuckerman A. Fulminant hepatic failure in leukaemia and choriocarcinoma related to withdrawal of cytotoxic drug therapy. Lancet. 1975;2:528-30. 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Scand J Rheumatol. 1987;16:229-34. CrossrefMedlineGoogle Scholar9. Lanse S, Arnold G, Gowans J, and Kaplan M. Low incidence of hepatotoxicity associated with long-term, low-dose oral methotrexate in treatment of refractory psoriasis, psoriatic arthritis, and rheumatoid arthritis. An acceptable risk/benefit ratio. Dig Dis Sci. 1985;30:104-9. CrossrefMedlineGoogle Scholar10. Rosenthal G, Germolec D, Lamm K, Ackerman M, and Luster M. Comparative effects on the immune system of methotrexate and trimetrexate. Int J Immunopharmacol. 1987;9:793-801. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Michele A. Flowers, MD; Jenny Heathcote, MB, BS, MD; Ian R. Wanless, MD; Morris Sherman, MB, BCh, PhD; William J. Reynolds, MD; Ross G. Cameron, MD, PhD; Gary A. Levy, MD; Robert D. Inman, MDFrom the University of Toronto, Toronto, Ontario, Canada. For current author addresses, see end of text. 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Potential for therapeutic interventionReactivation of hepatitis B virus replication in patients receiving cytotoxic therapyTherapeutic challenges in Asia: hepatitis B and CInflammatory bowel disease coexistent with viral hepatitis and HIV 1 March 1990Volume 112, Issue 5 Page: 381-382 Keywords Chronic hepatitis B Drug therapy Hepatitis A virus Hepatitis B Hepatitis B virus Immune system Liver diseases Methotrexate Viral replication ePublished: 1 December 2008 Issue Published: 1 March 1990 PDF downloadLoading ...