De Pauli S, Grando M, Miotti G, Zeppieri M. Hepatitis B virus reactivation in patients treated with monoclonal antibodies. World J Virol 2024; 13(1): 88487 [PMID: 38616853 DOI: 10.5501/wjv.v13.i1.88487]
Corresponding Author of This Article
Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, Udine 33100, Italy. markzeppieri@hotmail.com
Research Domain of This Article
Virology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Virol. Mar 25, 2024; 13(1): 88487 Published online Mar 25, 2024. doi: 10.5501/wjv.v13.i1.88487
Hepatitis B virus reactivation in patients treated with monoclonal antibodies
Silvia De Pauli, Martina Grando, Giovanni Miotti, Marco Zeppieri
Silvia De Pauli, Martina Grando, Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento, Pordenone 33170, Italy
Giovanni Miotti, Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Co-first authors: Silvia De Pauli and Martina Grando.
Author contributions: Grando M, De Pauli S and Zeppieri M wrote the outline; Grando M and De Pauli S performed the research and wrote the manuscript together as co-authors; Grando M, De Pauli S, Miotti G, and Zeppieri M assisted in the writing of the paper; Zeppieri M was responsible for the conception and design of the study and completed the English and scientific editing; Grando M, De Pauli S, Miotti G and Zeppieri M assisted in the editing and making critical revisions to the manuscript. Although authors are from different areas of specialization, all authors provided general information and details regarding Hepatitis B virus reactivation based on the literature review. Each author participated in the research and writing of the paper, even if not directly pertinent to the area of study, considering the multidisciplinary approach in managing these patients. All authors provided the final approval of the article.
Conflict-of-interest statement: The authors declare having no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, Udine 33100, Italy. markzeppieri@hotmail.com
Received: September 26, 2023 Peer-review started: September 26, 2023 First decision: November 23, 2023 Revised: November 23, 2023 Accepted: December 19, 2023 Article in press: December 19, 2023 Published online: March 25, 2024
Abstract
Hepatitis B virus (HBV) reactivation poses a significant clinical challenge, especially in patients undergoing immunosuppressive therapies, including monoclonal antibody treatments. This manuscript briefly explores the complex relationship between monoclonal antibody therapy and HBV reactivation, drawing upon current literature and clinical case studies. It delves into the mechanisms underlying this phenomenon, highlighting the importance of risk assessment, monitoring, and prophylactic measures for patients at risk. The manuscript aims to enhance the understanding of HBV reactivation in the context of monoclonal antibody therapy, ultimately facilitating informed clinical decision-making and improved patient care. This paper will also briefly review the definition of HBV activation, assess the risks of reactivation, especially in patients treated with monoclonal antibodies, and consider management for patients with regard to screening, prophylaxis, and treatment. A better understanding of patients at risk can help clinicians provide optimum management to ensure successful patient outcomes and prevent morbidity.
Core Tip: Reactivation of hepatitis B (HBV) induces a rapid and acute increase in viral replication in a patient with chronic HBV infection or prior HBV exposure. There is also an increased risk of HBV reactivation in patients treated with monoclonal antibodies. Organ damage can be due to various mechanisms and risk factors that activate the cascade of inflammatory responses, such as direct infection. It is of clinical importance to diagnose, manage, and treat individuals, especially those at risk. Patient outcomes, success of therapy, prevention of complications, and management of existing comorbidities depend on the correct multidisciplinary management in patients at risk.
