Case Report: Hepatitis B virus reactivation following rituximab therapy in a patient receiving maintenance hemodialysis.

OBJECTIVE

To investigate a case of hepatitis B virus reactivation (HBV-R) in a post-lymphoma patient with renal transplantation and long-term maintenance hemodialysis (MHD), and to explore prevention strategies for high-risk populations.

METHODS

Patient records were reviewed for dialysis history, HBV markers, and liver function. Environmental sampling was conducted, and a multidisciplinary team established individualized management as well as optimized screening and vaccination strategies.

RESULTS

The patient had undergone maintenance hemodialysis since February 2023 with stable hepatitis B virus (HBV) serology. In March 2024, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and HBV DNA tested positive. The patient had received intermittent chemotherapy and rituximab at another hospital during dialysis. Following reactivation, the patient was transferred to dedicated dialysis equipment with isolation nursing care, strict infection control measures, and environmental monitoring. A multidisciplinary team refined high-risk patient screening and reinforced vaccination programs.

CONCLUSION

Hemodialysis patients under prolonged immunosuppression face elevated HBV reactivation risk. Early identification and risk-based management are essential to reduce adverse impacts on patient safety and healthcare quality.