APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy

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Lau G., Yu M., Wong G., Thompson A., Ghazinian H., Hou J., ...More

HEPATOLOGY INTERNATIONAL, vol.15, no.5, pp.1031-1048, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 15 Issue: 5
  • Publication Date: 2021
  • Doi Number: 10.1007/s12072-021-10239-x
  • Journal Name: HEPATOLOGY INTERNATIONAL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.1031-1048
  • Keywords: APASL, Hepatitis B reactivation, Immunosuppressive therapy, Guideline, VIRUS HBV REACTIVATION, BONE-MARROW-TRANSPLANTATION, STEM-CELL TRANSPLANTATION, ACTING ANTIVIRAL THERAPY, PREEMPTIVE LAMIVUDINE, RHEUMATOID-ARTHRITIS, LYMPHOMA PATIENTS, POSITIVE PATIENTS, SURFACE-ANTIGEN, CANCER-PATIENTS
  • Ankara University Affiliated: Yes

Abstract

Background & Aim Hepatitis B reactivation related to the use of immunosuppressive therapy remains a major cause of liver-related morbidity and mortality in hepatitis B endemic Asia-Pacific region. This clinical practice guidelines aim to assist clinicians in all disciplines involved in the use of immunosuppressive therapy to effectively prevent and manage hepatitis B reactivation. Methods All publications related to hepatitis B reactivation with the use of immunosuppressive therapy since 1975 were reviewed. Advice from key opinion leaders in member countries/administrative regions of Asian-Pacific Association for the study of the liver was collected and synchronized. Immunosuppressive therapy was risk-stratified according to its reported rate of hepatitis B reactivation. Recommendations We recommend the necessity to screen all patients for hepatitis B prior to the initiation of immunosuppressive therapy and to administer pre-emptive nucleos(t)ide analogues to those patients with a substantial risk of hepatitis and acute-on-chronic liver failure due to hepatitis B reactivation.