Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04570.x/abstract;jse\

ssionid=14B286AFA1D2E672D81ABA1E900EF64C.d03t01

Review article: prevention and management of hepatitis B and C infection in

patients with inflammatory bowel disease

J. P. Gisbert1,2, M. Chaparro1,2, M. Esteve3Article first published online: 11

JAN 2011

DOI: 10.1111/j.1365-2036.2010.04570.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Articles online in advance of print)

Summary

Background  Viral hepatitis is a very common infection.

Aim  To review the prevention and management of hepatitis B virus (HBV) and

hepatitis C virus (HCV) infection in inflammatory bowel disease (IBD).

Methods  Bibliographical searches were performed in MEDLINE up to September

2010.

Results  The prevalence of both HBV and HCV infection in IBD patients is now

similar to that of the general population. All IBD patients should be screened

for HBV markers at diagnosis. Liver dysfunction in IBD patients treated with

immunosuppressants is more frequent and severe in HBV than in HCV carriers and

is associated with combined immunosuppression. In patients receiving anti-TNF

drugs, HBV reactivation is common unless anti-viral prophylaxis is administered.

HBsAg-positive patients should receive anti-viral prophylaxis before starting

immunosuppressants. As interferon might worsen underlying IBD,

nucleoside/nucleotide analogues are preferred for anti-viral prophylaxis in

patients with HBV (tenofovir/entecavir are preferred to lamivudine). IBD

patients should be vaccinated against HBV at diagnosis. The response rate to HBV

vaccination is low, mainly in those receiving anti-TNF therapy. The serological

response to HBV vaccine should be confirmed, and patients with an inadequate

response should receive a second full series of vaccine. Peginterferon

(±ribavirin) for HCV infection is as effective and safe as in non-IBD patients.

Conclusions  The present manuscript poses a series of questions on the

prevention and management of HBV/HCV infection in IBD, and attempts to answer

them using scientific evidence in order to provide practical conclusions for the

clinician.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04570.x/abstract;jse\

ssionid=14B286AFA1D2E672D81ABA1E900EF64C.d03t01

Review article: prevention and management of hepatitis B and C infection in

patients with inflammatory bowel disease

J. P. Gisbert1,2, M. Chaparro1,2, M. Esteve3Article first published online: 11

JAN 2011

DOI: 10.1111/j.1365-2036.2010.04570.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Articles online in advance of print)

Summary

Background  Viral hepatitis is a very common infection.

Aim  To review the prevention and management of hepatitis B virus (HBV) and

hepatitis C virus (HCV) infection in inflammatory bowel disease (IBD).

Methods  Bibliographical searches were performed in MEDLINE up to September

2010.

Results  The prevalence of both HBV and HCV infection in IBD patients is now

similar to that of the general population. All IBD patients should be screened

for HBV markers at diagnosis. Liver dysfunction in IBD patients treated with

immunosuppressants is more frequent and severe in HBV than in HCV carriers and

is associated with combined immunosuppression. In patients receiving anti-TNF

drugs, HBV reactivation is common unless anti-viral prophylaxis is administered.

HBsAg-positive patients should receive anti-viral prophylaxis before starting

immunosuppressants. As interferon might worsen underlying IBD,

nucleoside/nucleotide analogues are preferred for anti-viral prophylaxis in

patients with HBV (tenofovir/entecavir are preferred to lamivudine). IBD

patients should be vaccinated against HBV at diagnosis. The response rate to HBV

vaccination is low, mainly in those receiving anti-TNF therapy. The serological

response to HBV vaccine should be confirmed, and patients with an inadequate

response should receive a second full series of vaccine. Peginterferon

(±ribavirin) for HCV infection is as effective and safe as in non-IBD patients.

Conclusions  The present manuscript poses a series of questions on the

prevention and management of HBV/HCV infection in IBD, and attempts to answer

them using scientific evidence in order to provide practical conclusions for the

clinician.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04570.x/abstract;jse\

ssionid=14B286AFA1D2E672D81ABA1E900EF64C.d03t01

Review article: prevention and management of hepatitis B and C infection in

patients with inflammatory bowel disease

J. P. Gisbert1,2, M. Chaparro1,2, M. Esteve3Article first published online: 11

JAN 2011

DOI: 10.1111/j.1365-2036.2010.04570.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Articles online in advance of print)

Summary

Background  Viral hepatitis is a very common infection.

Aim  To review the prevention and management of hepatitis B virus (HBV) and

hepatitis C virus (HCV) infection in inflammatory bowel disease (IBD).

Methods  Bibliographical searches were performed in MEDLINE up to September

2010.

Results  The prevalence of both HBV and HCV infection in IBD patients is now

similar to that of the general population. All IBD patients should be screened

for HBV markers at diagnosis. Liver dysfunction in IBD patients treated with

immunosuppressants is more frequent and severe in HBV than in HCV carriers and

is associated with combined immunosuppression. In patients receiving anti-TNF

drugs, HBV reactivation is common unless anti-viral prophylaxis is administered.

HBsAg-positive patients should receive anti-viral prophylaxis before starting

immunosuppressants. As interferon might worsen underlying IBD,

nucleoside/nucleotide analogues are preferred for anti-viral prophylaxis in

patients with HBV (tenofovir/entecavir are preferred to lamivudine). IBD

patients should be vaccinated against HBV at diagnosis. The response rate to HBV

vaccination is low, mainly in those receiving anti-TNF therapy. The serological

response to HBV vaccine should be confirmed, and patients with an inadequate

response should receive a second full series of vaccine. Peginterferon

(±ribavirin) for HCV infection is as effective and safe as in non-IBD patients.

Conclusions  The present manuscript poses a series of questions on the

prevention and management of HBV/HCV infection in IBD, and attempts to answer

them using scientific evidence in order to provide practical conclusions for the

clinician.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04570.x/abstract;jse\

ssionid=14B286AFA1D2E672D81ABA1E900EF64C.d03t01

Review article: prevention and management of hepatitis B and C infection in

patients with inflammatory bowel disease

J. P. Gisbert1,2, M. Chaparro1,2, M. Esteve3Article first published online: 11

JAN 2011

DOI: 10.1111/j.1365-2036.2010.04570.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Articles online in advance of print)

Summary

Background  Viral hepatitis is a very common infection.

Aim  To review the prevention and management of hepatitis B virus (HBV) and

hepatitis C virus (HCV) infection in inflammatory bowel disease (IBD).

Methods  Bibliographical searches were performed in MEDLINE up to September

2010.

Results  The prevalence of both HBV and HCV infection in IBD patients is now

similar to that of the general population. All IBD patients should be screened

for HBV markers at diagnosis. Liver dysfunction in IBD patients treated with

immunosuppressants is more frequent and severe in HBV than in HCV carriers and

is associated with combined immunosuppression. In patients receiving anti-TNF

drugs, HBV reactivation is common unless anti-viral prophylaxis is administered.

HBsAg-positive patients should receive anti-viral prophylaxis before starting

immunosuppressants. As interferon might worsen underlying IBD,

nucleoside/nucleotide analogues are preferred for anti-viral prophylaxis in

patients with HBV (tenofovir/entecavir are preferred to lamivudine). IBD

patients should be vaccinated against HBV at diagnosis. The response rate to HBV

vaccination is low, mainly in those receiving anti-TNF therapy. The serological

response to HBV vaccine should be confirmed, and patients with an inadequate

response should receive a second full series of vaccine. Peginterferon

(±ribavirin) for HCV infection is as effective and safe as in non-IBD patients.

Conclusions  The present manuscript poses a series of questions on the

prevention and management of HBV/HCV infection in IBD, and attempts to answer

them using scientific evidence in order to provide practical conclusions for the

clinician.