Department of Medicine, Division of Gastroenterology and Hepatology, Vejthani Hospital, 1 Soi Lat Phrao 111, Khlong Chan, Bang Kapi District, Bangkok 10240, Thailand.
Department of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, 3400 Spruce Street, 2 Dulles HUP, Philadelphia, PA 19104, USA.
Clin Liver Dis. 2020 Aug;24(3):317-333. doi: 10.1016/j.cld.2020.04.002. Epub 2020 May 26.
Hepatitis B virus (HBV) reactivation, in the background of cleared and overt chronic HBV infection, can be seen in patients receiving immunosuppressive agents. Risk of reactivation is variably associated with HBV serologic status and types of immunosuppressive therapy. Prevention of HBV reactivation by antiviral prophylaxis is an effective strategy to reduce morbidity and mortality in those with immunocompromised states. This article defines HBV reactivation, discusses risk stratification and common medications that can induce HBV reactivation as well as guideline recommendations for prevention of HBV reactivation, and describes the prognosis and management of patients who experience HBV reactivation.
乙型肝炎病毒 (HBV) 再激活是指在清除和显性慢性 HBV 感染的背景下，接受免疫抑制剂治疗的患者会出现 HBV 再激活。再激活的风险与 HBV 血清学状态和免疫抑制治疗类型有关。通过抗病毒预防来预防 HBV 再激活是减少免疫抑制状态患者发病率和死亡率的有效策略。本文定义了 HBV 再激活，讨论了风险分层和可能诱导 HBV 再激活的常见药物，以及预防 HBV 再激活的指南建议，并描述了经历 HBV 再激活的患者的预后和管理。
