Reactivation of Hepatitis B Virus and Its Prevention in Patients with Rheumatic Diseases Receiving Immunosuppressive Therapy.
10.4078/jrd.2017.24.5.261
- Author:
Eun Jung PARK
1
;
Kyu Sik CHOI
;
Byung Cheol SONG
Author Information
1. Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea. drsong8177@naver.com
- Publication Type:Review
- Keywords:
Hepatitis B reactivation;
Immunosuppressive agents;
Rheumatic diseases
- MeSH:
B-Lymphocytes;
Biological Factors;
Hepatitis B Surface Antigens;
Hepatitis B virus*;
Hepatitis B*;
Hepatitis*;
Humans;
Immunosuppression;
Immunosuppressive Agents;
Incidence;
Liver Failure;
Necrosis;
Rheumatic Diseases*;
Rituximab
- From:Journal of Rheumatic Diseases
2017;24(5):261-270
- CountryRepublic of Korea
- Language:English
-
Abstract:
Introduction of biologic agents to treat patients with rheumatic diseases and cancer has improved clinical outcomes. However, this advance increases the risk of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen carrier and even in resolved HBV infection, which can lead to liver failure and even death. In particular, the risk of HBV reactivation is heightened by the use of B-cell depleting agents such as rituximab, high dose corticosteroid, and anti-tumor necrosis factor-α. Therefore, identification of individuals at risk, and understanding the mechanism of HBV reactivation are essential to preventing HBV reactivation before initiating immunosuppressive therapy. Here, we review the mechanism, incidence, and prevention of HBV reactivation in the setting of immunosuppression.
