Hepatitis B reactivation related to everolimus

Reactivation of hepatitis B virus (HBV) during chemotherapy is a well known complication in patients with chronic hepatitis B and cancer.The clinical manifestations range from subclinical elevation of liver enzymes to severe,potentially fatal fulminant hepatitis.Reactivation can occur in a patient with previous inactive HBV infection;either an inactive carrier or a patient with resolved hepatitis.Everolimus is a mammalian target of rapamycin (mTOR) inhibitor approved in renal cell carcinoma,neuroendocrine tumours and breast cancer.mTOR inhibitors are a new generation of drugs for targeted treatment;therefore,little about their side effects is known.Here,we report a patient with renal cell carcinoma who experienced a flare of hepatitis B infection during treatment with everolimus.Clinicians should be aware of HBV reactivation in patients who are undergoing treatment with everolimus,and screening for hepatitis B infection and prophylactic antiviral treatment should be considered.