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Current Hepatology Reports
Published in: Current Hepatology Reports 3/2014

Open Access 01-09-2014 | Hepatitis B (P Martin and P Lampertico, Section Editors)

Immunosuppression in Patients with Chronic Hepatitis B

Authors: Anil Seetharam, Robert Perrillo, Robert Gish

Published in: Current Hepatology Reports | Issue 3/2014

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Abstract

After hepatitis B virus (HBV) infection, HBV DNA persists in minute amounts in hepatocyte nuclei even in individuals with “resolved” infection. Viral replication and development of liver disease depend on the balance between viral mechanisms promoting persistence and host immune control. Patients with active or inactive disease or resolved HBV infection are at risk for reactivation with immunosuppressive therapy use. HBV reactivation varies from a clinically asymptomatic condition to one associated with acute liver failure and death. We review recent studies on HBV reactivation during immunomodulatory therapies for oncologic, gastroenterological, rheumatic, and dermatologic disorders. Risk calculation should be determined through HBV screening and assessment of immunosuppressive therapy potency. We also discuss monitoring for reactivation, prophylactic antiviral therapy, and treatment of reactivation. Prophylactic antiviral treatment is needed for all HBsAg carriers and selected patients who have anti-HBc without HBsAg and is critical for preventing viral reactivation and improving outcomes.
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Metadata
Title
Immunosuppression in Patients with Chronic Hepatitis B
Authors
Anil Seetharam
Robert Perrillo
Robert Gish
Publication date
01-09-2014
Publisher
Springer US
Published in
Current Hepatology Reports / Issue 3/2014
Electronic ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-014-0238-2

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