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

George Lau, Ming Lung Yu, Grace Wong, Alexander Thompson, Hasmik Ghazinian, Jin Lin Hou, Teerha Piratvisuth, Ji Dong Jia, Masashi Mizokami, Gregory Cheng, Guo Feng Chen, Zhen Wen Liu, Oidov Baatarkhuu, Ann Lii Cheng, Woon Leung Ng, Patrick Lau, Tony Mok, Jer Ming Chang, Saeed Hamid, A. Kadir DokmeciRino A. Gani, Diana A. Payawal, Pierce Chow, Joong Won Park, Simone I. Strasser, Rosmawaiti Mohamed, Khin Maung Win, Tanwandee Tawesak, Shiv Kumar Sarin, Masao Omata

Research output: Contribution to journalArticlepeer-review

58 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1031-1048
Number of pages18
JournalHepatology International
Volume15
Issue number5
DOIs
Publication statusPublished - Oct 2021

Keywords

  • APASL
  • Guideline
  • Hepatitis B reactivation
  • Immunosuppressive therapy

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