APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy

• Published in: Hepatology international Vol. 15; no. 5; pp. 1031 - 1048
• Main Authors: Lau, George, Yu, Ming-Lung, Wong, Grace, Thompson, Alexander, Ghazinian, Hasmik, Hou, Jin-Lin, Piratvisuth, Teerha, Jia, Ji-Dong, Mizokami, Masashi, Cheng, Gregory, Chen, Guo-Feng, Liu, Zhen-Wen, Baatarkhuu, Oidov, Cheng, Ann Lii, Ng, Woon Leung, Lau, Patrick, Mok, Tony, Chang, Jer-Ming, Hamid, Saeed, Dokmeci, A. Kadir, Gani, Rino A., Payawal, Diana A., Chow, Pierce, Park, Joong-Won, Strasser, Simone I., Mohamed, Rosmawaiti, Win, Khin Maung, Tawesak, Tanwandee, Sarin, Shiv Kumar, Omata, Masao
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.10.2021; Springer Nature B.V
• Subjects: Antiviral Agents; Clinical medicine; Clinical practice guidelines; Colorectal Surgery; Guidelines; Hepatitis; Hepatitis B; Hepatitis B - drug therapy; Hepatitis B - prevention & control; Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis B, Chronic - drug therapy; Hepatology; Humans; Immunosuppressive agents; Immunosuppressive Agents - adverse effects; Liver; Liver diseases; Medicine; Medicine & Public Health; Morbidity; Opinion leaders; Patients; Surgery; Therapy; Virus Activation; Guideline; APASL; Immunosuppressive therapy; Hepatitis B reactivation
• ISSN: 1936-0533; 1936-0541; 1936-0541
• DOI: 10.1007/s12072-021-10239-x

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.