scholarly journals Reactivation of hepatitis B virus infection in rheumatic diseases: risk and management considerations

2020 ◽  
Vol 12 ◽  
pp. 1759720X2091264 ◽  
Author(s):  
Christos Koutsianas ◽  
Konstantinos Thomas ◽  
Dimitrios Vassilopoulos
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Rheumatic Diseases ◽  
Antiviral Treatment ◽  
Immunosuppressive Treatment ◽  
Immunosuppressive Drugs ◽  
Janus Kinase ◽  
Virus Reactivation ◽  
Specific Risk ◽  
B Virus

In patients with rheumatic diseases undergoing immunosuppressive treatment, hepatitis B virus reactivation (HBVr) has been long recognized as a major treatment-related adverse event with substantial morbidity and mortality. Because HBVr is easily preventable with appropriate screening and monitoring strategies, and, when indicated, prophylactic antiviral treatment, awareness of this complication is of the utmost importance, especially in the era of biologic treatments. As a condition, it continues to be topical, in view of the emergence of novel classes of immunosuppressive drugs (i.e. Janus kinase inhibitors) acquiring licenses for a variety of rheumatic diseases. The class-specific risk of these agents for HBVr has not yet been determined. Moreover, ambiguity still exists for the management of patients planned to be treated with traditional agents, such as cyclophosphamide and glucocorticoids, particularly in the setting of resolved HBV infection. Clinicians in the field of rheumatic diseases should be tailoring their practice according to the host’s profile and treatment-specific risk for HBVr. In this review, the authors attempt to critically review the existing literature and provide practical advice on these issues.

scholarly journals Hepatitis B Virus Reactivation in Gastrointestinal Stromal Tumor Patients Treated With Imatinib

2021 ◽  
Vol 10 ◽  
Author(s):  
Tianxiang Lei ◽  
Fengbo Tan ◽  
Zhouhua Hou ◽  
Peng Liu ◽  
Xianhui Zhao ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Rare Complication ◽  
Antiviral Treatment ◽  
Neoadjuvant Treatment ◽  
Virus Reactivation ◽  
Primary Tumors ◽  
Hepatitis B Virus Reactivation ◽  
Extracorporeal Liver Support ◽  
B Virus

PurposeHepatitis B virus reactivation (HBVr) in patients with gastrointestinal stromal tumors (GISTs) have not been sufficiently characterized. This study aimed to review the possible mechanism of HBVr induced by imatinib and explore appropriate measures for patient management and monitoring.MethodsThe clinical data of GIST patients who experienced HBVr due to treatment with imatinib at Xiangya Hospital (Changsha, Hunan, China) were retrospectively analyzed. A literature review was also conducted.ResultsFive cases were analyzed, including 3 cases in this study. The average age of the patients was 61.8 y, with male preponderance (4 of 5 vs. 1 of 5). These patients received imatinib as adjuvant treatment (n=4) or as neoadjuvant treatment (n=1). Primary tumors were mostly located in the stomach (n=4) or rectum (n=1). High (n=3) or intermediate (n=1) recurrence risk was categorized using the postoperative pathological results (n=4). Imatinib was then started at 400 (n=4) or 200 mg (n=1) daily. Patients first reported abnormal liver function during the 2th (n=1),6th (n=3), or 10th (n=1) month of treatment with imatinib. Some patients (n=4) discontinued imatinib following HBVr; notably, 1 month after discontinuation, 1 patient experienced HBVr. Antivirals (entecavir n=4, tenofovir n=1), artificial extracorporeal liver support (n=1), and liver transplant (n=1) were effective approaches to treating HBVr. Most patients (n=3) showed favorable progress, 1 patient underwent treatment, and 1 patient died due to severe liver failure induced by HBVr.ConclusionsAlthough HBVr is a rare complication (6.12%), HBV screening should be conducted before starting treatment with imatinib in GIST patients. Prophylactic therapy for hepatitis B surface antigen positive patients, prompt antiviral treatment and cessation of imatinib are also necessary.

scholarly journals Hematological Malignancies and HBV Reactivation: Suggestions for Clinical Management

2019 ◽  
Author(s):  
Alessandra Zannella ◽  
Massimo Marignani ◽  
Paola Begini
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hematological Malignancies ◽  
Immunosuppressive Drugs ◽  
Viral Reactivation ◽  
Hbv Reactivation ◽  
Virus Reactivation ◽  
Hepatitis B Virus Reactivation ◽  
B Virus ◽  
Clinical Consequences

It is well known that the event of hepatitis B virus reactivation can occur among patients undergoing treatment for hematological malignancies. In this paper we will present the available data regarding the risk of hepatitis B virus reactivation in this special population of immunosuppressed patients and explore the relevance of an accurate prevention and management of this condition. A computerized literature search was performed using appropriate terms arrangement, including English-written literature only or additional relevant articles. The evaluation of hepatitis B reactivation risk is a multidimensional process, which includes conducting an accurate clinical and physical history, considering the virological categories, the knowledge of the medication chosen to treat these hematological malignancies and the induced grade of immunosuppression. Adopting adequate preventive strategies and surveillance according to the current international recommendations is crucial to prevent HBVr and its dire clinical consequences (hepatitis, liver failure, interruption of lifesaving anti-neoplastic treatments). Universal HBV screening of patients scheduled to undergo treatment for hematological malignancies should be the chosen policy, and clinicians should be aware of the inherent risk of viral reactivation among the different virological categories and the classes of immunosuppressive drugs.

scholarly journals Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment: A multicenter study

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0201316 ◽  
Author(s):  
Baek Gyu Jun ◽  
Young Don Kim ◽  
Sang Gyune Kim ◽  
Young Seok Kim ◽  
Soung Won Jeong ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Multicenter Study ◽  
Antiviral Treatment ◽  
Virus Reactivation ◽  
Hepatitis B Virus Reactivation ◽  
B Virus

scholarly journals Management of Hepatitis B Virus Reactivation in Malignant Lymphoma Prior to Immunosuppressive Treatment

2021 ◽  
Vol 11 (4) ◽  
pp. 267
Author(s):  
Yu-Fen Tsai ◽  
Chin-Mu Hsu ◽  
Hui-Hua Hsiao
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Immunosuppressive Treatment ◽  
Hbv Reactivation ◽  
Virus Reactivation ◽  
Common Complication ◽  
Cell Immunotherapy ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Agent Treatment

Hepatitis B reactivation is a common complication in lymphoma patients under immunosuppressive treatment with potentially serious and life-threating consequences. In this review, we discuss the basis of chronic Hepatitis B virus (HBV) infection, the definition and risk factors for HBV reactivation. We overview the management of HBV reactivation based on virological status and immunosuppressive regimen risk stratification. We also highlight and update information about the HBV reactivation in lymphoma patients under novel agent treatment, including newer monoclonal antibodies, small molecule inhibitors, and even chimeric antigen receptor T-cell immunotherapy.

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