Fulltext

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

Lau G 1 , Yu ML 2 , Wong G 3 , Thompson A 4 , Ghazinian H 5 , Hou JL 6 Show all authors , Piratvisuth T 7 , Jia JD 8 , Mizokami M 9 , Cheng G 10 , Chen GF 11 , Liu ZW 12 , Baatarkhuu O 13 , Cheng AL 14 , Ng WL 15 , Lau P 16 , Mok T 17 , Chang JM 18 , Hamid S 19 , Dokmeci AK 20 , Gani RA 21 , Payawal DA 22 , Chow P 23 , Park JW 24 , Strasser SI 25 , Mohamed R 26 , Win KM 27 , Tawesak T 28 , Sarin SK 29 , Omata M 30

Affiliations 

  • 1 Humanity and Health Clinical Trial Center, Humanity and Health Medical Group, Hong Kong SAR, China. gkklau@hnhmgl.com
  • 2 Hepatitis Center and Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tz-You 1st Rd, Chinese Taipei, Kaohsiung, Taiwan. fish6069@gmail.com
  • 3 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
  • 4 St Vincent's Hospital, Melbourne, VIC, Australia
  • 5 Department of Hepatology, Nork Clinical Hospital of Infectious Diseases, Yerevan, Armenia
  • 6 Department of Infectious Diseases, Institute of Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 7 Department of Medicine, NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Prince of Songkla University, Hat Yai, Thailand
  • 8 Liver Research Center, Beijing Friendship Hospital, Beijing, China
  • 9 Genome Medical Science Project, National Center for Global Health and Medicine, Ichikawa, Japan
  • 10 The Fifth Medical Center of Chinese, PLA General Hospital, Beijing, 100039, China
  • 11 Department of Liver Diseases, Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China
  • 12 Research Center for Liver Transplantation, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
  • 13 Department of Infectious Diseases, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
  • 14 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 15 Department of Medicine, United Christian Hospital, Hong Kong SAR, China
  • 16 Humanity and Health Clinical Trial Center, Humanity and Health Medical Group, Hong Kong SAR, China
  • 17 Department of Clinical Oncology, State Key Laboratory of South China, Chinese University of Hong Kong, Hong Kong SAR, China
  • 18 Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  • 19 Department of Medicine, Aga Khan University and Hospital, Stadium Road, Karachi, 74800, Pakistan
  • 20 Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
  • 21 Liver Transplantation Team, Ciptomangunkusumo Hospital, Jakarta, Indonesia
  • 22 Department of Medicine, Cardinal Santos Medical Center, Mandaluyong, Metro, Manila, Philippines
  • 23 Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore
  • 24 Center for Liver Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
  • 25 AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, Australia
  • 26 Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 27 Yangon Gastroenterology and Liver Centre, Yangon, Myanmar
  • 28 Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 29 Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
  • 30 Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu-shi, Yamanashi, 400-8506, Japan
Hepatol Int, 2021 Oct;15(5):1031-1048.
PMID: 34427860 DOI: 10.1007/s12072-021-10239-x

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications