Immunosuppression in Patients with Chronic Hepatitis B
After hepatitis B virus (HBV) infection, HBV DNA persists in minute amounts in hepatocyte nuclei even in individuals with “resolved” infection. Viral replication and development of liver disease depend on the balance between viral mechanisms promoting persistence and host immune control. Patients wi...
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| Format: | Online |
| Language: | English |
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Springer US
2014
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119588/ |
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pubmed-41195882014-08-04 Immunosuppression in Patients with Chronic Hepatitis B Seetharam, Anil Perrillo, Robert Gish, Robert Hepatitis B (P Martin and P Lampertico, Section Editors) After hepatitis B virus (HBV) infection, HBV DNA persists in minute amounts in hepatocyte nuclei even in individuals with “resolved” infection. Viral replication and development of liver disease depend on the balance between viral mechanisms promoting persistence and host immune control. Patients with active or inactive disease or resolved HBV infection are at risk for reactivation with immunosuppressive therapy use. HBV reactivation varies from a clinically asymptomatic condition to one associated with acute liver failure and death. We review recent studies on HBV reactivation during immunomodulatory therapies for oncologic, gastroenterological, rheumatic, and dermatologic disorders. Risk calculation should be determined through HBV screening and assessment of immunosuppressive therapy potency. We also discuss monitoring for reactivation, prophylactic antiviral therapy, and treatment of reactivation. Prophylactic antiviral treatment is needed for all HBsAg carriers and selected patients who have anti-HBc without HBsAg and is critical for preventing viral reactivation and improving outcomes. Springer US 2014-06-21 2014 /pmc/articles/PMC4119588/ /pubmed/25101233 http://dx.doi.org/10.1007/s11901-014-0238-2 Text en © The Author(s) 2014 Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Seetharam, Anil Perrillo, Robert Gish, Robert |
| spellingShingle |
Seetharam, Anil Perrillo, Robert Gish, Robert Immunosuppression in Patients with Chronic Hepatitis B |
| author_facet |
Seetharam, Anil Perrillo, Robert Gish, Robert |
| author_sort |
Seetharam, Anil |
| title |
Immunosuppression in Patients with Chronic Hepatitis B |
| title_short |
Immunosuppression in Patients with Chronic Hepatitis B |
| title_full |
Immunosuppression in Patients with Chronic Hepatitis B |
| title_fullStr |
Immunosuppression in Patients with Chronic Hepatitis B |
| title_full_unstemmed |
Immunosuppression in Patients with Chronic Hepatitis B |
| title_sort |
immunosuppression in patients with chronic hepatitis b |
| description |
After hepatitis B virus (HBV) infection, HBV DNA persists in minute amounts in hepatocyte nuclei even in individuals with “resolved” infection. Viral replication and development of liver disease depend on the balance between viral mechanisms promoting persistence and host immune control. Patients with active or inactive disease or resolved HBV infection are at risk for reactivation with immunosuppressive therapy use. HBV reactivation varies from a clinically asymptomatic condition to one associated with acute liver failure and death. We review recent studies on HBV reactivation during immunomodulatory therapies for oncologic, gastroenterological, rheumatic, and dermatologic disorders. Risk calculation should be determined through HBV screening and assessment of immunosuppressive therapy potency. We also discuss monitoring for reactivation, prophylactic antiviral therapy, and treatment of reactivation. Prophylactic antiviral treatment is needed for all HBsAg carriers and selected patients who have anti-HBc without HBsAg and is critical for preventing viral reactivation and improving outcomes. |
| publisher |
Springer US |
| publishDate |
2014 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119588/ |
| _version_ |
1613120206010318848 |