TY - JOUR A2 - Schifferli, Jürg AU - Sagnelli, Evangelista AU - Pisaturo, Mariantonietta AU - Sagnelli, Caterina AU - Coppola, Nicola PY - 2012 DA - 2012/08/05 TI - Rituximab-Based Treatment, HCV Replication, and Hepatic Flares SP - 945950 VL - 2012 AB - Rituximab, a chimeric mouse-human monoclonal antibody directed to the CD20 antigen expressed on pre-B lymphocytes and mature lymphocytes, causes a profound B-cell depletion. Due to its peculiar characteristics, this drug has been used to treat oncohaematological diseases, B cell-related autoimmune diseases, rheumatoid arthritis, and, more recently, HCV-associated mixed cryoglobulinaemic vasculitis. Rituximab-based treatment, however, may induce an increased replication of several viruses such as hepatitis B virus, cytomegalovirus, varicella-zoster virus, echovirus, and parvovirus B19. Recent data suggest that rituximab-based chemotherapy induces an increase in HCV expression in hepatic cells, which may become a target for a cell-mediated immune reaction after the withdrawal of treatment and the restoration of the immune control. Only a few small studies have investigated the occurrence of HCV reactivation and an associated hepatic flare in patients with oncohaematological diseases receiving R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). These studies suggest that the hepatic flares are frequently asymptomatic, but life-threatening liver failure occurs in nearly 10% of cases. SN - 2314-8861 UR - https://doi.org/10.1155/2012/945950 DO - 10.1155/2012/945950 JF - Clinical and Developmental Immunology PB - Hindawi Publishing Corporation KW - ER -