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Viral hepatitis: manifestations and management strategy
Roberto J Firpi1, David R Nelson
1Division of Gastroenterology, Hepatology and Nutrition, Section of Hepatobiliary Diseases and Liver Transplantation, University of Florida, Gainesville, FL 32610, USA.
Hematology. American Society of Hematology. Education Program
|November 25, 2006
Summary
Viral hepatitis is a major risk for liver disease in transplant patients. Early screening and antiviral prophylaxis are crucial for managing hepatitis B and C, reducing long-term complications like cirrhosis and liver cancer.
Area of Science:
- Hepatology
- Transplant Medicine
- Infectious Diseases
Background:
- Viral hepatitis is a leading cause of liver disease in allogeneic transplant recipients.
- It significantly contributes to morbidity and mortality in this patient population.
- Hematological malignancy patients require focused screening for viral hepatitis risk.
Purpose of the Study:
- To emphasize the importance of identifying and screening at-risk patients for viral hepatitis.
- To outline screening protocols and management strategies for viral hepatitis in transplant recipients.
- To discuss the impact of viral hepatitis on short-term and long-term outcomes after transplantation.
Main Methods:
- Review of current literature on viral hepatitis in allogeneic transplant recipients.
- Analysis of screening serology including anti-HCV, HBsAg, anti-HBs, and anti-HBc.
- Discussion of prophylaxis strategies for hepatitis B reactivation and management of HCV infection.
Main Results:
- Hepatitis B exposure necessitates nucleoside analogue prophylaxis for HBsAg-positive patients.
- HCV infection has minimal short-term impact but increases risks for VOD and GVHD.
- Long-term HCV infection is linked to cirrhosis, decompensation, and liver cancer.
Conclusions:
- Routine screening and targeted intervention for viral hepatitis are recommended.
- Effective antiviral therapies exist for both hepatitis B and C.
- Management strategies aim to minimize acute and chronic morbidity in transplant recipients.
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