Hepatitis B virus (HBV) reactivation with imatinib, a tyrosine kinase inhibitor, has been reported in
chronic myeloid leukemia. Nilotinib is a more potent second generation tyrosine kinase inhibitor and
it inhibits the Src-family kinase LCK and hamper proliferation and function of CD8 (+) T lymphocytes.
CD8 (+) T lymphocytes are the main cellular subset responsible for viral clearance in patients with HBV
infection. We report a case of HBV reactivation under treatment with nilotinib. Fatal HBV reactivation is
not usually related to death in chronic myeloid leukemia patients who have an expectation of longevity
with well-tolerated oral drugs. Thus, screening for latent chronic HBV infections including assessment
of hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc antibody) and
antibody to hepatitis B surface antigen (anti-HBs), especially at countries with intermediate and high
prevalence of HBsAg is warranted. Treatment with nucleoside analogs and close monitoring may be
life-saving in this context.