Korean J Gastroenterol.  2019 Nov;74(5):258-266. 10.4166/kjg.2019.74.5.258.

Prophylactic Antiviral Treatment in Immunosuppressed Chronic Hepatitis B Patients

• Yoon EL

• KMID: 2464184
• DOI: http://doi.org/10.4166/kjg.2019.74.5.258

Abstract

Improved management of chronic hepatitis B patients with oral nucleos(t)ide analogues has increased the number of these patients who are getting older and have other accompanying comorbidities. These comorbidities frequently require various immunosuppression treatments and/or cytotoxic chemotherapy. Not only the patients who are positive for HBsAg, but also the patients who are positive for isolated anti-HBc are at risk for hepatitis B reactivation during immunosuppression. Prophylactic antiviral treatment with oral nucleos(t)ide analogues with high genetic barriers can decrease the risks of HBV reactivation, HBV reactivation-associated hepatitis, and mortality in these patients. It is crucial to screen HBV markers in all of the patients who have to undergo immunosuppression, be administered prophylactic antiviral treatment in the high risk groups, and be monitored for HBV reactivation during and after immunosuppression and/or cytotoxic chemotherapy. This study summarizes the recommendations from the recently updated guidelines from Korea, United States, and Europe.

Keyword

Hepatitis B, chronic; Immunosuppression; Reactivation; Prophylactic

MeSH Terms

Comorbidity
Drug Therapy
Europe
Hepatitis
Hepatitis B
Hepatitis B Surface Antigens
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Immunosuppression
Korea
Mortality
United States
Hepatitis B Surface Antigens

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