Treatment of special populations with chronic hepatitis B infection

Rapti, Irene; Hadziyannis, Stephanos J.

doi:10.1586/egh.11.7

Cited by 15 publications

(18 citation statements)

References 109 publications

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“…Kesin bir hükümde bulunmak için, emzirilen bebeklerin prospektif olarak izlendikleri daha büyük ölçekteki çalışmala-rın sonuçlarına gereksinim duyulmaktaysa da güncel öneriler uygun immünoprofilaksi almış yenidoğanların emzirilmeleri yönündedir (1,3,4,6,7,9,(12)(13)(14)18).…”

Section: Hbv'nin Anneden çOcuğa Geçiş Yollarıunclassified

“…HBsAg-pozitif annelerin temas sonrası immünoprofilaksi uygulanmayan bebeklerinde KHB gelişme-si riski, HBeAg-pozitif olanlarda %70-90 iken, HBeAg-negatif olanlarda <%10'dur (2,4,8,18). HBeAg'nin immünoregülatuar işlevi olduğu kabul edilmektedir ve klinik olarak viral replikasyonu ve bulaşma riskinin fazla olduğunu gösterir (1,2).…”

Section: Vertikal Bulaşma İçin Risk Faktörleriunclassified

“…Ancak bu yolla intrauterin bulaşma engellenmiş olmaz. Son çalışmalar ışığında yenidoğanın aktif ve pasif hepatit B profilaksisi uygun bir biçimde yapılabilecekse, gebeye sezaryen indikasyonu konmaması gerektiği belirtilmektedir (3,4,6,10,(12)(13)(14)18).…”

Section: Vertikal Bulaşma Riskinin Azaltılmasıunclassified

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Management of Chronic Hepatitis B in Pregnancy: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

Aygen¹,

Keten²,

Akalın³

et al. 2014

Klimik Dergisi

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ÖzetTürk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Viral Hepatit Çalışma Grubu, bazı üyelerine, gerek ileri dönemde bir karaciğer hastalığı olan anne için, gerekse hepatit B virusu (HBV) bulaşması riski altındaki doğmamış çocuk için, karmaşık bir sorun oluşturan gebelikte kronik hepatit B yönetimi üzerine odaklanan bir uzlaşı raporu hazırlama görevini vermiştir. Raporda konuyla ilgili literatür ve uluslararası kılavuzlar gözden geçirilmiş ve üzerinde uzlaşılan öneriler sunulmuştur. Gebe hastada kronik hepatit B yönetimi için güncel yayınlardan uyarlanan bir algoritm de önerilmiştir. Doğurganlık çağındaki birçok kadın infeksiyonun immün toleran fazında olduğu için genellikle tedavi edilmeleri gerekmez ve gebeliğin erken dö-nemlerinde tedaviye başlama indikasyonu yoktur. Uygulanan postnatal pasif ve aktif immünoprofilaksiye karşın anneden ço-cuğa HBV bulaşması, yüksek derecede viremik (HBV DNA >200 000 İÜ/ml) gebelerde üçüncü trimestrin başında antiviral tedaviye başlanmasıyla önlenebilir. Potensi ve dirence karşı yüksek genetik bariyeri göz önüne alındığında, tenofovir, aktif hepatit B için tedavileri doğumdan sonra da sürdürülecek annelerde uygun bir seçenek olabilir. AbstractStudy Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases set up a task force to develop a consensus report focused on chronic hepatitis B in pregnancy, a complex issue for both the mother with an advanced liver disease and the unborn child who is under the risk of hepatitis B virus (HBV) transmission. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented in the report. An algorithm adapted from actual publications is also proposed for management of chronic hepatitis B in the pregnant patient. Since many women of childbearing age are in the immune tolerant phase of infection, there is generally no need for therapy and no indication to start therapy during the early stages of pregnancy. Initiation of antiviral therapy in the beginning of the third trimester in highly viremic (HBV DNA >200 000 IU/mL) pregnant women can prevent mother-to-child-transmission of HBV despite postnatal passive and active immunoprophylaxis provided. Given its potency and its high genetic barrier to resistance, tenofovir might be an appropriate option for mothers who might need to continue their treatment for active hepatitis B after delivery. Klimik Dergisi 2013; 26(Suppl. 1): 12-9.

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Section: Hbv'nin Anneden çOcuğa Geçiş Yollarıunclassified

Section: Vertikal Bulaşma İçin Risk Faktörleriunclassified

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Management of Chronic Hepatitis B in Pregnancy: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

Aygen¹,

Keten²,

Akalın³

et al. 2014

Klimik Dergisi

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“…This group includes children, pregnant women, patients with acute and fulminant hepatitis B, decompensated cirrhosis, co-existing chronic renal disease, transplant subjects, and cancer patients on chemo-immunotherapy (13)(14)(15). These patients are more vulnerable to fatal hepatitis or HBV reactivation and are usually excluded from clinical trials (13,14).…”

mentioning

confidence: 99%

“…These patients are more vulnerable to fatal hepatitis or HBV reactivation and are usually excluded from clinical trials (13,14). They constitute a majority of those with CHB and require concerted research on optimizing antiviral therapy among this group of patients (13,14). Individuals with negative HBsAg assay are not completely free of the risk of reactivation of hepatitis since viral DNA and anti-HBc may persist as an occult hepatitis B infection (OBI) (16)(17)(18).…”

mentioning

confidence: 99%

Optimizing antiviral agents for hepatitis B management in malignant lymphomas

et al. 2017

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Abstract:The global scale of hepatitis B infection is well known but its impact is still being understood. Missed hepatitis B infection impacts lymphoma therapy especially increased risk of hepatitis B virus (HBV) reactivation and poor treatment outcomes. The presence of undiagnosed chronic hepatitis also undermines chronic HBV screening methods that are based on a positive HBsAg alone. The goal of this review is to evaluate the literature for optimizing antiviral therapy for lymphoma patients with HBV infection or at risk of HBV reactivation.Relevant articles for this review were identified by searching PubMed, Embase, Ovid Medline, and Scopus using the following terms, alone and in combination: "chronic hepatitis B", "occult hepatitis B", "special groups", "malignant lymphoma", "non-Hodgkin's lymphoma", "Hodgkin's lymphoma", "immunocompromised host", "immunosuppressive agents", "antiviral", "HBV reactivation". The period of the search was restricted to a 15-year period to limit the search to optimizing antiviral agents for HBV infection in malignant lymphomas [2001][2002][2003][2004][2005][2006][2007][2008][2009][2010][2011][2012][2013][2014][2015][2016].Several clinical practice guidelines recommend nucleos(t)ide analogues-entecavir, tenofovir and lamivudine among others. These agents are best initiated along with or prior to immunosuppressive therapy. Additional methods recommended for optimizing antiviral therapy include laboratory modalities such as HBV genotyping, timed measurements of HBsAg and HBV DNA levels to measure and predict antiviral treatment response. In conclusion, optimizing antiviral agents for these patients require consideration of geographic prevalence of HBV, cost of antiviral therapy or testing, screening modality, hepatitis experts, type of immunosuppressive therapy and planned duration of therapy. Prevalence of chronic hepatitis B (CHB) by region, age group and special groups (lymphoma)The hepatitis B virus (HBV) is a common human infection which belongs to the hepadnaviridae family. The chronic form of HBV infection is more prevalent than the acute type, and global estimate of chronic cases is 300 million or more (1-3). Despite the likelihood that 95% of adults will recover from an acute HBV infection, impaired viral clearance facilitates complications such as chronic hepatic inflammation, hepatocellular carcinoma and lymphomas (4-7). On a global scale, the mortality from HBV complications is estimated at about 780,000-1 million yearly and adds to existing burdens to health systems (2,8). Global estimates of CHB prevalence indicate high prevalence of CHB in the African and Western pacific region and countries with the highest number of HBsAg-positive individuals include China (74 million), India (17 million) and Nigeria (15 million) (9). Significant decrease in CHB prevalence has been recorded over the last 5 decades especially in countries Review Article on Treatment for Hepatitis B

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