Abstract
Hepatitis B virus (HBV) reactivation associated with various therapeutic interventions is an important cause of morbidity and mortality in patients with current or resolved HBV infection. Because no curative treatment for HBV infection is yet available, there are many individuals at risk for HBV reactivation in the general population. Populations at risk for HBV reactivation include patients who are currently infected with HBV or who have been exposed to HBV in the past. HBV reactivation and its potential consequences is a concern when these populations are exposed to anti-cancer chemotherapy, immunosuppressive or immunomodulatory therapies for the management of various malignancies, rheumatologic diseases, inflammatory bowel disease, or solid-organ or hematologic stem cell transplantation. Accordingly, it has become important to understand the basics of HBV reactivation and the mechanisms by which certain therapies are more susceptible to HBV reactivation. This review aims to raise the awareness of HBV reactivation and to understand the mechanisms and the risks of HBV reactivation in various clinical settings.
Highlights
Hepatitis B virus (HBV) infection is a global health concern
Even if the HBV infection is resolved in hepatitis B surface antigen (HBsAg)-negative and anti-HBc-positive patients, they are at risk for HBV reactivation when receiving immunosuppressive therapy, especially B cell-depleting agents or hematopoietic stem cell transplantation [21, 22]
In a large retrospective study of patients receiving long-term TNFα inhibitors, an HBV reactivation rate of 39% was reported in HBsAg-positive patients, whereas no reactivation occurred in patients with resolved HBV infection [6]
Summary
Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul, South Korea Reviewed by: Nazri Mustaffa, Universiti Sains Malaysia (USM), Malaysia Sergio Rodríguez Tajes, Hospital Clínic de Barcelona, Spain Specialty section: This article was submitted to Gastroenterology, a section of the journal
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