Screening and Prophylaxis to Prevent Hepatitis B Reactivation: Other Populations and Newer Agents

Clin Liver Dis. 2019 Aug;23(3):521-534. doi: 10.1016/j.cld.2019.04.012. Epub 2019 Jun 5.

Abstract

Because of the relatively high prevalence of both hepatitis B infection and various forms of autoimmune inflammatory diseases treated with aggressive immunotherapy, reactivation of hepatitis B occurs in a substantial number of patients. The risk of reactivation depends on the degree and duration of immunosuppression. A large number of drug treatments have resulted in reactivation of hepatitis B virus infection and, based on the mechanisms and extent of immunosuppression, recommendations for some of the newer classes of immunosuppressive drugs are provided.

Keywords: Anti-CD20; Direct-acting antivirals; Hepatitis B; Inflammatory bowel diseases; Reactivation; Rheumatoid arthritis.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / epidemiology
  • Arthritis, Rheumatoid / immunology*
  • Biological Products / therapeutic use*
  • Female
  • Hepatitis B Surface Antigens / drug effects
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B virus / physiology*
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / therapeutic use
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / immunology*
  • Male
  • Mass Screening
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Survival Analysis
  • Virus Activation / drug effects
  • Virus Activation / immunology*

Substances

  • Antiviral Agents
  • Biological Products
  • Hepatitis B Surface Antigens
  • Immunosuppressive Agents