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

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 o...

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Main Authors: Lau, George, Yu, Ming-Lung, Wong, Grace, Thompson, Alexander, Ghazinian, Hasmik, Hou, Jin-Lin, Piratvisuth, Teerha, Jia, Ji-Dong, Mizokami, Masashi, Cheng, Gregory, Chen, Guo-Feng, Liu, Zhen-Wen, Baatarkhuu, Oidov, Cheng, Ann Lii, Ng, Woon Leung, Lau, Patrick, Mok, Tony, Chang, Jer-Ming, Hamid, Saeed, Dokmeci, A. Kadir, Gani, Rino A., Payawal, Diana A., Chow, Pierce, Park, Joong-Won, Strasser I, Simone, Mohamed, Rosmawaiti, Win, Khin Maung, Tawesak, Tanwandee, Sarin, Shiv Kumar, Omata, Masao
Format: Article
Published: SPRINGER
Online Access:http://eprints.um.edu.my/34699/
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Summary: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.