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Current Hepatology Reports

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Open Access 28-02-2024 | Hepatitis B | Review

A Review of Hepatitis B Reactivation Risk on Immunosuppressants with a Focus on Newer Immunomodulators

Authors: Zahra Dossaji, Lubaba Haque, Adam Khattak, Mark Hsu, Robert Gish

Published in: Current Hepatology Reports | Issue 2/2024

Abstract

Purpose of Review

Hepatitis B virus reactivation (HBVr) can complicate the use of immunosuppressive, antiviral, and chemotherapeutic medications in individuals with a history of prior exposure to HBV or chronic infection. Timely management is crucial to prevent fatalities. This review focuses on the various classes of biologics linked to the risk of HBVr, with emphasis on newer immunosuppressive and immunomodulator therapies.

Recent Findings

Immune checkpoint inhibitors, tyrosine kinase inhibitors, cytokine inhibitors, and chimeric antigen receptor T-cell immunotherapies are associated with a high risk of hepatitis B virus reactivation (HBVr) in patients who are hepatitis B surface antigen-positive (HbsAg-positive). This risk decreases significantly when patients start nucleoside analogue (NA) prophylaxis. It is recommended to use NA prophylaxis alongside these medications and closely monitor for reactivation upon discontinuation of NA prophylaxis.

Summary

To minimize the risk of reactivation when starting immunosuppressive, antiviral, and chemotherapeutic agents in individuals at high, intermediate, and low risk for hepatitis B virus reactivation (HBVr), it is crucial to employ specific strategies for risk assessment, monitoring, and management.

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Title: A Review of Hepatitis B Reactivation Risk on Immunosuppressants with a Focus on Newer Immunomodulators
Authors: Zahra Dossaji
Lubaba Haque
Adam Khattak
Mark Hsu
Robert Gish
Publication date: 28-02-2024
Publisher: Springer US
Keywords: Hepatitis B
Immunomodulator
Entecavir
Published in: Current Hepatology Reports / Issue 2/2024
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-024-00662-7

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Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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Other articles of this Issue 2/2024

Expanding the Donor Pool for Liver Transplantation: Assessing the Potential Use of HBV-Positive Allografts

Hepatitis B Virus Elimination Strategies

When to Stop Antiviral Therapy in HBeAg-Negative Patients with Chronic Hepatitis B?

Treatment of Gastric Varices

Management of Hepatitis B in Pregnancy

Perspective on Emerging Therapies to Achieve Functional Cure of Chronic Hepatitis B

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