6533b85cfe1ef96bd12bca1d

RESEARCH PRODUCT

Prophylaxis and treatment of hepatitis B in immunocompromised patients.

A MarzanoE AngelucciP AndreoneM BrunettoR BrunoPatrizia BurraP CaraceniB DanieleV Di MarcoF FabriziS FagiuoliP GrossiP LamperticoR MeliconiA MangiaM PuotiG RaimondoA Smedile Italian Association For The Study Of The Liver

subject

HBsAgmedicine.medical_specialtyHepatitis C virusmedicine.medical_treatmentLiver transplantationTransplantmedicine.disease_causeGastroenterologyAntiviral AgentsImmunocompromised HostAnimals; Antiviral Agents; Carrier State; Hepatitis B; Hepatitis B Core Antigens; Hepatitis B Surface Antigens; Humans; Immunocompromised Host; Liver Transplantation; Tissue Donors; TransplantationAntivirals; HBV; Immunosuppression; Transplants;Internal medicineHBVMedicineAnimalsHumansAntiviralHepatitis B virusTransplantationHepatitis B Surface AntigensHepatologybusiness.industryGastroenterologyvirus diseasesHepatitis Bmedicine.diseaseHepatitis BHepatitis B Core Antigensdigestive system diseasesTissue DonorsLiver TransplantationTransplantationHBeAgImmunologyCarrier StateHepatitis D virusbusinessImmunosuppression

description

The literature on hepatitis B virus (HBV) in immunocompromised patients is heterogeneous and referred mainly to the pre-antivirals era. Today a rational approach to the problem of hepatitis B in these patients provides for: (a) the evaluation of HBV markers and of liver condition in all subjects starting immunosuppressive therapies (baseline), (b) the treatment with antivirals (therapy) of active carriers, (c) the pre-emptive use of antivirals (prophylaxis) in inactive carriers, especially if they are undergoing immunosuppressive therapies judged to be at high risk, (d) the biochemical and hepatitis B surface antigen (HBsAg) monitoring (or universal prophylaxis, in case of high risk immunosuppression) in subjects with markers of previous contact with HBV (HBsAg negative and anti-HBc positive), in order to prevent reverse seroconversion. Moreover it is suggested a strict adherence to criteria of allocation based on the virological characteristics of both recipients and donors in the general setting of transplants and in liver transplantation the universal prophylaxis with nucleos(t)ides analogues (frequently combined with specific anti-HBV immunoglobulins) in HBsAg positive candidates and in HBsAg negative recipients of anti-HBc positive grafts.

yearjournalcountryeditionlanguage
2007-05-01
http://hdl.handle.net/11577/1772285