Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5769
Peer-review started: January 29, 2021
First decision: March 29, 2021
Revised: April 12, 2021
Accepted: June 2, 2021
Article in press: June 2, 2021
Published online: July 26, 2021
Hepatitis B virus (HBV) reactivation can lead to severe acute hepatic failure and death in patients with HBV infection. HBV reactivation (HBVr) most commonly develops in patients undergoing cancer chemotherapy, especially B cell-depleting agent therapy such as rituximab and ofatumumab for hematological or solid organ malignancies and that receiving hematopoietic stem cell transplantation without antiviral prophylaxis. In addition, the potential consequences of HBVr is particularly a concern when patients are exposed to either immunosuppressive or biologic therapies for the management of rheumatologic diseases, inﬂammatory bowel disease and dermatologic diseases. Thus, screening with HBV serological markers and prophylactic or pre-emptive antiviral treatment with nucleos(t)ide analogues should be considered in these patients to diminish the risk of HBVr. This review discusses the clinical manifestation, prognosis and management of HBVr, risk stratifications of cancer chemotherapy and immunosuppressive therapy and international guideline recommendations for the prevention of HBVr in patients with HBV infection and resolved hepatitis B.
Core Tip: Reactivation of hepatitis B virus (HBV) could be fatal in the patients with hepatitis B infection and chemotherapy or immunosuppressive therapy. We review the risk of HBV reactivation, screening of HBV infection and the strategies of prophylaxis of HBV reactivation in patients requiring chemotherapy and immunosuppressive therapy.