Prevention of hepatitis B virus reactivation in immunosuppressive therapy or chemotherapy

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http://www.mdlinx.com/infectious-disease/newsl-article.cfm/3630915/ZZ68065536792\

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Prevention of hepatitis B virus reactivation in immunosuppressive therapy or

chemotherapy

Clinical and Experimental Nephrology, 06/07/2011  

Ohishi W et al. – The risk of HBV reactivation rises as the level of

immunosuppression intensifies, but in recent years hepatitis B virus(HBV)

reactivation risk has been clearly shown to increase in cases of rituximab plus

steroid–containing regimen for treatment of malignant lymphoma. In particular,

the incidence of fulminant hepatitis caused by HBV reactivation in cases with

resolved HBV infection is reported to be higher than that brought about by acute

hepatitis B.

• All cases in which immunosuppressive therapy or chemotherapy treatment

regimens are used, screening for HBV infection and appropriate management in

accordance with the status of HBV–related markers are crucial, aimed at

preventing occurrence of HBV reactivation.

• Foundation of the aforementioned management, regardless of HBsAg status, is

administration of nucleoside analogues, with their powerful anti–viral

properties, when HBV DNA levels reach detectable levels.

___________________________________________________________________

http://www.springerlink.com/content/182430694m6515p2/

Clinical and Experimental Nephrology

DOI: 10.1007/s10157-011-0464-7Online Firstâ„¢

Review Article

Prevention of hepatitis B virus reactivation in immunosuppressive therapy or

chemotherapy

Waka Ohishi and Kazuaki ma

Abstract

In recent years, hepatitis B virus (HBV) has been found to reproliferate either

during or following immunosuppressive therapy or chemotherapy, with hepatitis

caused by HBV reactivation now considered a serious issue. HBV reactivation is

categorized into occurrence in HBsAg- and anti-HBe-positive asymptomatic

carriers, and in HBsAg-negative, anti-HBc low-titer-positive, and/or

anti-HBs-positive resolved HBV infection cases. Despite the fact that

“clinical cure†is claimed for such resolved HBV cases, low levels of

ongoing HBV production are now recognized as being sustained within the liver or

in peripheral blood mononuclear cells, with the infection thus now considered to

be virologically persistent. The risk of HBV reactivation rises as the level of

immunosuppression intensifies, but in recent years HBV reactivation risk has

been clearly shown to increase in cases of rituximab plus steroid-containing

regimen for treatment of malignant lymphoma. In particular, the incidence of

fulminant hepatitis caused by HBV reactivation in cases with resolved HBV

infection is reported to be higher than that brought about by acute hepatitis B.

Therefore, for all cases in which immunosuppressive therapy or chemotherapy

treatment regimens are used, screening for HBV infection and appropriate

management in accordance with the status of HBV-related markers are crucial,

aimed at preventing occurrence of HBV reactivation. The foundation of the

aforementioned management, regardless of HBsAg status, is administration of

nucleoside analogues, with their powerful anti-viral properties, when HBV DNA

levels reach detectable levels.

[Guest guest]

http://www.mdlinx.com/infectious-disease/newsl-article.cfm/3630915/ZZ68065536792\

5639220014/?news_id=497 & newsdt=060711 & subspec_id=130

Prevention of hepatitis B virus reactivation in immunosuppressive therapy or

chemotherapy

Clinical and Experimental Nephrology, 06/07/2011  

Ohishi W et al. – The risk of HBV reactivation rises as the level of

immunosuppression intensifies, but in recent years hepatitis B virus(HBV)

reactivation risk has been clearly shown to increase in cases of rituximab plus

steroid–containing regimen for treatment of malignant lymphoma. In particular,

the incidence of fulminant hepatitis caused by HBV reactivation in cases with

resolved HBV infection is reported to be higher than that brought about by acute

hepatitis B.

• All cases in which immunosuppressive therapy or chemotherapy treatment

regimens are used, screening for HBV infection and appropriate management in

accordance with the status of HBV–related markers are crucial, aimed at

preventing occurrence of HBV reactivation.

• Foundation of the aforementioned management, regardless of HBsAg status, is

administration of nucleoside analogues, with their powerful anti–viral

properties, when HBV DNA levels reach detectable levels.

___________________________________________________________________

http://www.springerlink.com/content/182430694m6515p2/

Clinical and Experimental Nephrology

DOI: 10.1007/s10157-011-0464-7Online Firstâ„¢

Review Article

Prevention of hepatitis B virus reactivation in immunosuppressive therapy or

chemotherapy

Waka Ohishi and Kazuaki ma

Abstract

In recent years, hepatitis B virus (HBV) has been found to reproliferate either

during or following immunosuppressive therapy or chemotherapy, with hepatitis

caused by HBV reactivation now considered a serious issue. HBV reactivation is

categorized into occurrence in HBsAg- and anti-HBe-positive asymptomatic

carriers, and in HBsAg-negative, anti-HBc low-titer-positive, and/or

anti-HBs-positive resolved HBV infection cases. Despite the fact that

“clinical cure†is claimed for such resolved HBV cases, low levels of

ongoing HBV production are now recognized as being sustained within the liver or

in peripheral blood mononuclear cells, with the infection thus now considered to

be virologically persistent. The risk of HBV reactivation rises as the level of

immunosuppression intensifies, but in recent years HBV reactivation risk has

been clearly shown to increase in cases of rituximab plus steroid-containing

regimen for treatment of malignant lymphoma. In particular, the incidence of

fulminant hepatitis caused by HBV reactivation in cases with resolved HBV

infection is reported to be higher than that brought about by acute hepatitis B.

Therefore, for all cases in which immunosuppressive therapy or chemotherapy

treatment regimens are used, screening for HBV infection and appropriate

management in accordance with the status of HBV-related markers are crucial,

aimed at preventing occurrence of HBV reactivation. The foundation of the

aforementioned management, regardless of HBsAg status, is administration of

nucleoside analogues, with their powerful anti-viral properties, when HBV DNA

levels reach detectable levels.

[Guest guest]

http://www.mdlinx.com/infectious-disease/newsl-article.cfm/3630915/ZZ68065536792\

5639220014/?news_id=497 & newsdt=060711 & subspec_id=130

Prevention of hepatitis B virus reactivation in immunosuppressive therapy or

chemotherapy

Clinical and Experimental Nephrology, 06/07/2011  

Ohishi W et al. – The risk of HBV reactivation rises as the level of

immunosuppression intensifies, but in recent years hepatitis B virus(HBV)

reactivation risk has been clearly shown to increase in cases of rituximab plus

steroid–containing regimen for treatment of malignant lymphoma. In particular,

the incidence of fulminant hepatitis caused by HBV reactivation in cases with

resolved HBV infection is reported to be higher than that brought about by acute

hepatitis B.

• All cases in which immunosuppressive therapy or chemotherapy treatment

regimens are used, screening for HBV infection and appropriate management in

accordance with the status of HBV–related markers are crucial, aimed at

preventing occurrence of HBV reactivation.

• Foundation of the aforementioned management, regardless of HBsAg status, is

administration of nucleoside analogues, with their powerful anti–viral

properties, when HBV DNA levels reach detectable levels.

___________________________________________________________________

http://www.springerlink.com/content/182430694m6515p2/

Clinical and Experimental Nephrology

DOI: 10.1007/s10157-011-0464-7Online Firstâ„¢

Review Article

Prevention of hepatitis B virus reactivation in immunosuppressive therapy or

chemotherapy

Waka Ohishi and Kazuaki ma

Abstract

In recent years, hepatitis B virus (HBV) has been found to reproliferate either

during or following immunosuppressive therapy or chemotherapy, with hepatitis

caused by HBV reactivation now considered a serious issue. HBV reactivation is

categorized into occurrence in HBsAg- and anti-HBe-positive asymptomatic

carriers, and in HBsAg-negative, anti-HBc low-titer-positive, and/or

anti-HBs-positive resolved HBV infection cases. Despite the fact that

“clinical cure†is claimed for such resolved HBV cases, low levels of

ongoing HBV production are now recognized as being sustained within the liver or

in peripheral blood mononuclear cells, with the infection thus now considered to

be virologically persistent. The risk of HBV reactivation rises as the level of

immunosuppression intensifies, but in recent years HBV reactivation risk has

been clearly shown to increase in cases of rituximab plus steroid-containing

regimen for treatment of malignant lymphoma. In particular, the incidence of

fulminant hepatitis caused by HBV reactivation in cases with resolved HBV

infection is reported to be higher than that brought about by acute hepatitis B.

Therefore, for all cases in which immunosuppressive therapy or chemotherapy

treatment regimens are used, screening for HBV infection and appropriate

management in accordance with the status of HBV-related markers are crucial,

aimed at preventing occurrence of HBV reactivation. The foundation of the

aforementioned management, regardless of HBsAg status, is administration of

nucleoside analogues, with their powerful anti-viral properties, when HBV DNA

levels reach detectable levels.

[Guest guest]

http://www.mdlinx.com/infectious-disease/newsl-article.cfm/3630915/ZZ68065536792\

5639220014/?news_id=497 & newsdt=060711 & subspec_id=130

Prevention of hepatitis B virus reactivation in immunosuppressive therapy or

chemotherapy

Clinical and Experimental Nephrology, 06/07/2011  

Ohishi W et al. – The risk of HBV reactivation rises as the level of

immunosuppression intensifies, but in recent years hepatitis B virus(HBV)

reactivation risk has been clearly shown to increase in cases of rituximab plus

steroid–containing regimen for treatment of malignant lymphoma. In particular,

the incidence of fulminant hepatitis caused by HBV reactivation in cases with

resolved HBV infection is reported to be higher than that brought about by acute

hepatitis B.

• All cases in which immunosuppressive therapy or chemotherapy treatment

regimens are used, screening for HBV infection and appropriate management in

accordance with the status of HBV–related markers are crucial, aimed at

preventing occurrence of HBV reactivation.

• Foundation of the aforementioned management, regardless of HBsAg status, is

administration of nucleoside analogues, with their powerful anti–viral

properties, when HBV DNA levels reach detectable levels.

___________________________________________________________________

http://www.springerlink.com/content/182430694m6515p2/

Clinical and Experimental Nephrology

DOI: 10.1007/s10157-011-0464-7Online Firstâ„¢

Review Article

Prevention of hepatitis B virus reactivation in immunosuppressive therapy or

chemotherapy

Waka Ohishi and Kazuaki ma

Abstract

In recent years, hepatitis B virus (HBV) has been found to reproliferate either

during or following immunosuppressive therapy or chemotherapy, with hepatitis

caused by HBV reactivation now considered a serious issue. HBV reactivation is

categorized into occurrence in HBsAg- and anti-HBe-positive asymptomatic

carriers, and in HBsAg-negative, anti-HBc low-titer-positive, and/or

anti-HBs-positive resolved HBV infection cases. Despite the fact that

“clinical cure†is claimed for such resolved HBV cases, low levels of

ongoing HBV production are now recognized as being sustained within the liver or

in peripheral blood mononuclear cells, with the infection thus now considered to

be virologically persistent. The risk of HBV reactivation rises as the level of

immunosuppression intensifies, but in recent years HBV reactivation risk has

been clearly shown to increase in cases of rituximab plus steroid-containing

regimen for treatment of malignant lymphoma. In particular, the incidence of

fulminant hepatitis caused by HBV reactivation in cases with resolved HBV

infection is reported to be higher than that brought about by acute hepatitis B.

Therefore, for all cases in which immunosuppressive therapy or chemotherapy

treatment regimens are used, screening for HBV infection and appropriate

management in accordance with the status of HBV-related markers are crucial,

aimed at preventing occurrence of HBV reactivation. The foundation of the

aforementioned management, regardless of HBsAg status, is administration of

nucleoside analogues, with their powerful anti-viral properties, when HBV DNA

levels reach detectable levels.