Current trends in management of hepatitis B virus reactivation in the biologic therapy era

作     者：Claudio M Mastroianni Miriam Lichtner Rita Citton Cosmo Del Borgo Angela Rago Helene Martini Giuseppe Cimino Vincenzo Vullo 

作者机构：Infectious Diseases Unit Fondazione Eleonora Lorillard Spencer Cenci Sapienza University SM Goretti Hospital Hematology Unit Sapienza University SM Goretti Hospital Department of Public Health and Infectious Diseases Sapienza University Policlinico Umberto I 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2011年第17卷第34期

页      面：3881-3887页

核心收录：

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：生物治疗 乙肝病毒 激活 管理 抗病毒治疗 乙型肝炎病毒 肿瘤坏死因子 生物制剂 

摘      要：Hepatitis B virus (HBV) reactivation represents an emerging cause of liver disease in patients undergoing treatment with biologic agents. In particular, the risk ofHBV reactivation is heightened by the use monoclonalantibodies, such as rituximab (anti-CD20) and alemtuzumab (anti-CD52) that cause profound and longlasting immunosuppression. Emerging data indicatethat HBV reactivation could also develop following theuse of other biologic agents, such as tumor necrosis factor (TNF)-α inhibitors. When HBV reactivation is di-agnosed, it is mandatory to suspend biologic treatmentand start antiviral agents immediately. However, preemptive antiviral therapy prior to monoclonal antibodyadministration is crucial in preventing HBV reactivationand its clinical consequences. Several lines of evidencehave shown that risk of HBV reactivation is greatlyreduced by the identifi cation of high-risk patients andthe use of prophylactic antiviral therapy. In this article, we discuss current trends in the management of HBV reactivation in immunosuppressed patients receiving biologic therapy, such as rituximab, alemtuzumab and TNF-α antagonists.