Management of hepatitis B reactivation in immunosuppressed patients: An update on current recommendations

Figure 1 Hepatitis B reactivation phases. In the initial phase, there is an increase in HBV DNA levels, usually with an asymptomatic evolution. In the second phase, both ALT and HBV DNA are elevated; symptoms are frequently present, and they may be severe. The third phase is determined by resolution, although HBsAg (if reappeared), or elevated HBV DNA, may persist[3,17,55]. IS: Immunosuppression; HBV: Hepatitis B virus; ALT: Alanine aminotransferase; HBsAg: Hepatitis B surface antigen.

Figure 2 Immunosuppressing agents and related risk of hepatitis B reactivation. HCC: Hepatocellular carcinoma; TNF-α: Tumor necrosis factor-α; HBVr: Hepatitis B virus reactivation.

Figure 3 Risk factors for hepatitis B reactivation in patients with current/past hepatitis B infection. ALT: Alanine aminotransferase; HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; HBeAg: Hepatitis B e antigen; IS: Immunosuppression[2,4,27,56,57].