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Volume 32, Number 2—February 2026
Research Letter
Acute Severe Hepatitis B Virus Infection in Previously Vaccinated Patient during Acalabrutinib Treatment
Lukasz Rojek
, Tomasz Wnuk-Lipinski, Iwona Marek, Hubert Grabowski, and Krystian Adrych
, Tomasz Wnuk-Lipinski, Iwona Marek, Hubert Grabowski, and Krystian Adrych
Table 1
Blood test results from a case of severe HBV infection in previously vaccinated patient during acalabrutinib treatment*
| Biochemical parameter | Before HBV infection | Day of hospitalization |
||||||
|---|---|---|---|---|---|---|---|---|
| −13 | −3 | 0 | 1 | 2 | 3 | 4 | ||
| Total bilirubin, mg/dL |
0.84 |
2.19 |
23.04 |
43.02 |
32.17 |
33.76 |
33.89 |
35.66 |
| Alanine aminotransferase, U/L |
27 |
NA |
2,688 |
3,780 |
2,603 |
2,024 |
1,340 |
875 |
| Aspartate aminotransferase, U/L |
29 |
945 |
3,877 |
4,400 |
3,146 |
2,384 |
1,058 |
NA |
| Alkaline phosphatase, U/L |
NA |
NA |
212 |
211 |
164 |
NA |
147 |
NA |
| Gamma-glutamyltransferase, U/L |
NA |
NA |
421 |
233 |
171 |
NA |
107 |
NA |
| Ammonia, µmol/L |
NA |
NA |
NA |
221 |
NA |
NA |
92 |
NA |
| International normalized ratio |
NA |
NA |
2.89 |
>6.12 |
>6.12 |
>6.12 |
>8.6 |
>8.6 |
| Creatinine, mg/dL |
0.79 |
0.66 |
0.69 |
1.63 |
2.33 |
3.13 |
3.94 |
4.43 |
| Sodium, mmol/L |
141 |
136 |
136 |
129 |
126 |
121 |
118 |
117 |
| Potassium, mmol/L |
4.3 |
4.5 |
4.5 |
6.4 |
5.9 |
5.1 |
4.6 |
4.6 |
| Hemoglobin, g/dL |
13.7 |
13.9 |
NA |
14.3 |
11.8 |
11.1 |
9.9 |
9.5 |
| Erythrocytes, × 1012 cells/L |
4.02 |
4.13 |
NA |
4.4 |
3.55 |
3.38 |
3.0 |
2.9 |
| Platelets, × 109/L |
207 |
150 |
NA |
245 |
159 |
135 |
89 |
80 |
| Total leukocytes, × 109 cells/L |
8.01 |
6.1 |
NA |
8.33 |
7.43 |
6.24 |
5.27 |
5.04 |
| C-reactive protein, mg/L |
1.12 |
NA |
21.17 |
14.85 |
9.38 |
NA |
4.08 |
NA |
| Procalcitonin, ng/mL | NA | NA | NA | NA | 0.84 | 0.81 | NA | 0.61 |
*HBV, hepatitis B virus; NA, not available.
Page created: January 29, 2026
Page updated: February 09, 2026
Page reviewed: February 09, 2026
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