Rituximab BBW is which risk?

• A. HBV reactivation
• B. PML
• C. Infusion related reactions
• D. Hypoglycemia

Answer: (A)

Hepatitis B reactivation is the boxed warning clinicians emphasize with rituximab. By depleting B cells, rituximab can disrupt immune control of latent HBV in people who have been exposed, leading to reactivation that can progress to fulminant hepatitis, hepatic failure, and even death. Because of this, every patient should be screened for HBV before starting therapy (check HBsAg and anti-HBc). If there’s current or prior infection, antiviral prophylaxis (for example, entecavir or tenofovir) is recommended and continued for a period after completing rituximab. In those with resolved infection, prophylaxis or careful monitoring may be considered based on risk. PML is another serious risk associated with rituximab, but the strongest, most emphasized boxed warning relates to HBV reactivation. Infusion-related reactions are common and managed with standard precautions, while hypoglycemia is not a typical Rituximab concern.