Vatche and Tamar Manoukian Division of Digestive Diseases.
Pfleger Liver Institute, David Geffen School of Medicine at the University of California, Los Angeles, CA.
J Clin Gastroenterol. 2021;55(5):393-399. doi: 10.1097/MCG.0000000000001520.
Hepatitis B virus reactivation (HBVr) can occur spontaneously, but more often occurs when a patient is in an immunocompromised state or on immunosuppressive therapy. HBVr can lead to clinical hepatitis, acute liver failure, and even death. HBVr is preventable with screening of at-risk patients and initiation of prophylactic antiviral therapy for appropriate candidates. Screening for hepatitis B virus is recommended for all patients who plan to initiate immunosuppressive therapy. An individual's serological profile, underlying disease, and planned type of immunosuppression contribute to their risk of HBVr. This review serves to summarize the major society guidelines regarding screening, management of, and monitoring for HBVr in individuals on anticancer therapy and immunosuppressive therapy.
乙型肝炎病毒再激活（HBVr）可自发发生，但更常发生于免疫功能低下或接受免疫抑制治疗的患者。HBVr 可导致临床肝炎、急性肝功能衰竭，甚至死亡。通过对高危患者进行筛查并对合适的患者进行预防性抗病毒治疗，HBVr 是可以预防的。建议所有计划开始免疫抑制治疗的患者筛查乙型肝炎病毒。个体的血清学特征、基础疾病和计划接受的免疫抑制类型均与其 HBVr 风险相关。本综述旨在总结关于接受抗肿瘤治疗和免疫抑制治疗患者的 HBVr 筛查、管理和监测的主要学会指南。
