Shih CA, Chen WC. Prevention of hepatitis B reactivation in patients requiring chemotherapy and immunosuppressive therapy. World J Clin Cases 2021; 9(21): 5769-5781 [PMID: 34368296 DOI: 10.12998/wjcc.v9.i21.5769]
Corresponding Author of This Article
Wen-Chi Chen, MD, Chief Doctor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, No. 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan. wcchen@vghks.gov.tw
Research Domain of This Article
Gastroenterology & Hepatology
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 Clin Cases. Jul 26, 2021; 9(21): 5769-5781 Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5769
Prevention of hepatitis B reactivation in patients requiring chemotherapy and immunosuppressive therapy
Chih-An Shih, Wen-Chi Chen
Chih-An Shih, Wen-Chi Chen, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
Chih-An Shih, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Antai Medical Care Corporation, Antai Tian-Sheng Memorial Hospital, Pingtung County 928, Taiwan
Chih-An Shih, Department of Nursing, Meiho University, Pingtung County 928, Taiwan
Wen-Chi Chen, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
Wen-Chi Chen, Institute of Biomedical Sciences, College of Science, National Sun Yat-sen University, Kaohsiung 8424, Taiwan
Author contributions: Shih CA and Chen WC designed the research study, performed the research and wrote the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare having no conflict of interest.
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 NonCommercial (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/
Corresponding author: Wen-Chi Chen, MD, Chief Doctor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, No. 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan. wcchen@vghks.gov.tw
Received: January 29, 2021 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 Processing time: 172 Days and 15.1 Hours
Abstract
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.
