Hepatitis B virus reactivation in HBsAg-negative, anti-HBc-positive patients receiving immunosuppressive therapy: a systematic review

Haidich, Anna‐Bettina; Apostolidou-Kiouti, Fani; Chalevas, Parthenis; Papatheodoridis, George V.

doi:10.20524/aog.2018.0266

Cited by 47 publications

(70 citation statements)

References 65 publications

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“…A HBV reactivation rate of 6.5% during immunosuppressive treatment was reported, and the rate was higher in cases with hematological disorders or under rituximab treatment. 9 HBsAg-positive patients showed a higher rate of HBV reactivation than HBsAg-negative patients. 26 It has also been reported that negative or low HBsAb titer, immunosuppressive treatment duration of more than 1 year, combined immunosuppressants, advanced age and high-dose corticosteroids even for short courses can be risk factors for HBV reactivation.…”

Section: Discussionmentioning

confidence: 85%

“…In this study, serum HBV DNA turned positive during systemic corticosteroid treatment in 3.4% of cases. A HBV reactivation rate of 6.5% during immunosuppressive treatment was reported, and the rate was higher in cases with hematological disorders or under rituximab treatment . HBsAg‐positive patients showed a higher rate of HBV reactivation than HBsAg‐negative patients .…”

Section: Discussionmentioning

confidence: 99%

“…Patients in a weak, immunosuppressed state for a long time or even those who have ceased immunosuppressive therapy are still at risk for HBV reactivation . Therefore, a follow up of at least 12 months after the discontinuation of immunosuppression is recommneded . Once hepatitis B flares up, it can potentially be severe, and it is notable that most cases are asymptomatic and show normal liver function in the early phase …”

Section: Discussionmentioning

confidence: 99%

“…Surveys of oncologists and rheumatologists in Japan and other countries show low rates of hepatitis B virus (HBV) screening before chemotherapy or immunosuppressive therapy . The risk of HBV reactivation or Mycobacterium tuberculosis reactivation with systemic corticosteroid treatment has been shown in rheumatic and autoimmune diseases, although it has only rarely been investigated in dermatology …”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7] The risk of HBV reactivation or Mycobacterium tuberculosis reactivation with systemic corticosteroid treatment has been shown in rheumatic and autoimmune diseases, although it has only rarely been investigated in dermatology. [8][9][10][11] There are few guidelines for the screening of infectious diseases before the initiation of immunosuppressive treatments for skin disorders. [12][13][14] The medical board of the National Psoriasis Foundation in the USA recommends that psoriatic patients be screened for HBV infection before immunosuppressive medications are administrated.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of infectious diseases in patients with autoimmune blistering diseases

Ujiie

Yoshimoto

et al. 2020

The Journal of Dermatology

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A long‐term immunosuppressive treatment can provoke latent infections. Autoimmune blistering diseases (AIBD) are mostly treated with systemic immunosuppressive agents. To prevent the reactivation or exacerbation of existing latent infections, patients must be screened for infectious diseases before immunosuppressive treatments are initiated. However, the prevalence of infectious diseases in AIBD remains to be elucidated. To evaluate the necessity of screening infectious diseases in AIBD, we retrospectively reviewed the clinical records of 215 patients at a single center with AIBD for hepatitis B virus (HBV), hepatitis C virus (HCV), Mycobacterium tuberculosis, Treponema pallidum, human T‐cell leukemia virus type 1 (HTLV‐1) and HIV infections. Approximately 40% of patients were infected with HBV. During systemic corticosteroid treatment, HBV DNA became positive in 3.4% of cases. Antibodies to HCV, interferon‐γ release assays for M. tuberculosis and the T. pallidum latex agglutination test were positive in 0.6%, 6.6% and 1.2% cases, respectively. Neither HTLV‐1 nor HIV infections were detected. In conclusion, checks for HBV and M. tuberculosis infections should be made before immunosuppressive treatments are started, because of the high prevalence of these potentially life‐threatening infections. Other infections should be tested for depending on the patient’s risk factors.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence of infectious diseases in patients with autoimmune blistering diseases

Ujiie

Yoshimoto

et al. 2020

The Journal of Dermatology

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Preventing infectious complications when treating non‐malignant immune‐mediated hematologic disorders

2019

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Immunosuppressants, targeted antibody therapies, and surgical splenectomy are amongst the treatment choices for immune-mediated non-malignant hematologic disorders, with infection being the most common non-hematological adverse event from these therapies. Corticosteroids are associated with a length-of-treatment and dose-dependent risk for infection, including opportunistic infections. Screening and antimicrobial prophylaxis against tuberculosis, Strongyloides stercoralis, and Pneumocystis jirovecii pneumonia, are indicated in selected patients on steroids and with certain risk factors for infection. Rituximab is associated with hepatitis B virus reactivation. All patients planned to be started on rituximab should be screened for hepatitis B surface antigen and total core antibody, with antiviral prophylaxis given depending on test results. In eculizumab treated patients, immunization against meningococcal serogroups ACWY and B is recommended. In addition, some guidelines suggest antibiotic prophylaxis for the duration of eculizumab treatment. In splenectomized patients, counseling and immunization are cornerstones of infection prevention. Several federal and society guidelines about immunizations and prophylactic antimicrobial therapies for patients treated with various immunosuppressive agents exist and are summarized in this manuscript in a clinical-focused table. In addition, management suggestions are made where no formal guidelines exist. 2 | PATIENT COUNSELING An important part of infectious disease prevention in immunocompromised patients entails the education of the patient, family, and friends. Household and other close contacts of persons with altered immunocompetence should be educated in hand hygiene and avoid contact with the patient when they are experiencing an infectious process. 12 Proper food and water hygiene measures are important to prevent

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Risk of HBV reactivation during therapies for HCC: A systematic review

et al. 2021

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Background and Aims:Treatment for HCC has evolved rapidly, but the risk of HBV reactivation to new therapies is unclear. We systematically reviewed data on HBV reactivation in patients receiving HCC therapy in relation to use of HBV antiviral prophylaxis. Approach and Results:A literature search was performed to identify all published studies including HBsAg-positive patients with HCC providing data on HBV reactivation. Forty-one studies with 10,223 patients, all from Asia, were included. The pooled HBV reactivation rate was 5% in patients receiving no specific HCC therapy and was higher in patients undergoing surgical resection (16%), transarterial chemoembolization (19%), or radiotherapy (14%) and intermediate in patients treated with local ablation therapy (7%) or systemic agents (7%). HBV reactivation rates were higher in those without compared to those with HBV prophylaxis (ablation, 9% versus 0%; resection, 20% versus 3%; chemoembolization, 23% versus 1%; external radiotherapy alone, 18% versus 0%; systemic therapy, 9% versus 3%). HBV-related biochemical reactivation rates varied between 6%-11% and 2% in patients receiving HCC therapies with high and intermediate HBV reactivation risk, respectively.Liver decompensation and death were rarely reported (0%-3%) and only in patients receiving HCC treatment with high HBV reactivation risk. Conclusions: HBsAg-positive patients with HCC are at high or intermediate risk of HBV reactivation depending on the type of HCC therapy. Nucleos(t)ide analogue prophylaxis reduces the risk of HBV reactivation, practically eliminates the risk of hepatitis flare, and should be administered regardless of HCC treatment. This study included patients with HCC treated with no specific HCC therapy or TACE. c This study included patients with HCC treated with no specific HCC therapy, ethanol injection, surgical resection, or TACE. d This study included patients with HCC treated with ablation therapy or TACE. e This study included patients with HCC treated with ablation therapy or surgical resection. f This study included patients with HCC treated with surgical resection or TACE. g This study included patients with HCC treated with radiotherapy with or without TACE. h This study included patients with HCC treated with sorafenib. i This study included patients with HCC treated with sorafenib with or without TACE. j This study included patients with HCC treated with immune checkpoint inhibitors. k This study included patients with HCC treated with immune checkpoint inhibitors with or without antiangiogenetic factors or locoregional therapy. l 72 HBsAg-positive and 6 HBsAg-negative and anti-HBc-positive patients. m 55 HBsAg-positive and 7 HBsAg-negative and anti-HBc-positive patients.

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Hepatitis B virus reactivation in HBsAg-negative, anti-HBc-positive patients receiving immunosuppressive therapy: a systematic review

Cited by 47 publications

References 65 publications

Prevalence of infectious diseases in patients with autoimmune blistering diseases

Prevalence of infectious diseases in patients with autoimmune blistering diseases

Preventing infectious complications when treating non‐malignant immune‐mediated hematologic disorders

Risk of HBV reactivation during therapies for HCC: A systematic review

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