Hepatitis B in patients with hematological diseases: An update

作     者：Chiara Coluccio Paola Begini Alfredo Marzano Adriano Pellicelli Barbara Imperatrice Giulia Anania Gianfranco Delle Fave Massimo Marignani 

作者机构：Dig-estive and Liver Diseases DepartmentSant’Andrea HospitalSchool of Medicine and PsychologySapienza University Division of Gastroenterology and Hepatology San Giovanni Battista Hospital Liver UnitSan Camillo Forlanini Hospital 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2017年第9卷第25期

页      面：1043-1053页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Reactivation Lymphoma Hematology Immunosuppressive therapy Prophylaxis Hepatitis B virus Chemotherapy Occult/active/inactive carrier Entecavir Lamivudine 

摘      要：Hepatitis B virus(HBV) reactivation(HBVr) in patients undergoing immunosuppressive therapy is still a hot topic worldwide. Its prevention and management still represents a challenge for specialists dealing with immunosuppressed patients. Aim of this paper is to provide a critical review of the relevant information emerged in the recent literature regarding HBV reactivation following immunosuppressive treatments for oncohematological tumors. A computerized literature search in MEDLINE was performed using appropriate terms arrangement, including English-written literature only or additional relevant articles. Articles published only in abstract form and case reports not giving considerable news were excluded. Clinical manifestation of HBVr can be manifold, ranging from asymptomatic self-limiting anicteric hepatitis to life-threatening fulminant liver failure. In clusters of patients adverse outcomes are potentially predictable. Clinicians should be aware of the inherent risk of HBVr among the different virological categories(active carriers, occult HBV carriers and inactive carriers, the most intriguing category), and classes of immunosuppressive drugs. We recommend that patients undergoing immunosuppressive treatments for hematological malignancies should undergo HBV screening. In case of serological sign(s) of current or past infection with the virus, appropriate therapeutic or preventive strategies are suggested, according to both virological categories, risk of HBVr by immunosuppressive drugsand liver status. Either antiviral drug management and surveillance and pre-emptive approach are examined, commenting the current international recommendations about this debated issue.