APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy
Journal
Hepatology International
Journal Volume
15
Journal Issue
5
Pages
1031-1048
Date Issued
2021
Author(s)
Lau G.
Yu M.-L.
Wong G.
Thompson A.
Ghazinian H.
Hou J.-L.
Piratvisuth T.
Jia J.-D.
Mizokami M.
Cheng G.
Chen G.-F.
Liu Z.-W.
Baatarkhuu O.
Ng W.L.
Lau P.
Mok T.
Chang J.-M.
Hamid S.
Dokmeci A.K.
Gani R.A.
Payawal D.A.
Chow P.
Park J.-W.
Strasser S.I.
Mohamed R.
Win K.M.
Tawesak T.
Sarin S.K.
Omata M.
Abstract
Background & Aim: Hepatitis B reactivation related to the use of immunosuppressive therapy remains a major cause of liver-related morbidity and mortality in hepatitis B endemic Asia-Pacific region. This clinical practice guidelines aim to assist clinicians in all disciplines involved in the use of immunosuppressive therapy to effectively prevent and manage hepatitis B reactivation. Methods: All publications related to hepatitis B reactivation with the use of immunosuppressive therapy since 1975 were reviewed. Advice from key opinion leaders in member countries/administrative regions of Asian-Pacific Association for the study of the liver was collected and synchronized. Immunosuppressive therapy was risk-stratified according to its reported rate of hepatitis B reactivation. Recommendations: We recommend the necessity to screen all patients for hepatitis B prior to the initiation of immunosuppressive therapy and to administer pre-emptive nucleos(t)ide analogues to those patients with a substantial risk of hepatitis and acute-on-chronic liver failure due to hepatitis B reactivation. ? 2021, Asian Pacific Association for the Study of the Liver.
Subjects
APASL; Guideline; Hepatitis B reactivation; Immunosuppressive therapy
SDGs
Other Subjects
biological product; hepatitis B core antibody; hepatitis B surface antigen; monoclonal antibody; nucleoside analog; antivirus agent; hepatitis B surface antigen; immunosuppressive agent; Article; chronic liver failure; clinical assessment; coinfection; hepatitis B; Hepatitis B virus; hepatologist; human; immunopathogenesis; immunosuppressive treatment; infection risk; liver function test; morbidity; mortality rate; patient care; practice guideline; risk assessment; risk factor; virus reactivation; chronic hepatitis B; hepatitis B; virus activation; Antiviral Agents; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis B, Chronic; Humans; Immunosuppressive Agents; Virus Activation
Publisher
Springer
Type
journal article