Related Experiment Video
Updated: Jun 12, 2026
07:25
Stem Cell-Derived Viral Ag-Specific T Lymphocytes Suppress HBV Replication in Mice
Published on: September 25, 2019
Managing HBV in patients with impaired immunity
Karsten Wursthorn1, Heiner Wedemeyer, Michael P Manns
1Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl Neuberg-Strasse 1, Hannover, Germany.
Gut
|June 8, 2010
Summary
Hepatitis B virus (HBV) reactivation poses a significant risk in immunocompromised patients, including those with HIV/HBV coinfection or undergoing chemotherapy. Proactive antiviral treatment is crucial for preventing severe liver disease and mortality.
Area of Science:
- Hepatology
- Immunology
- Infectious Diseases
Background:
- Chronic hepatitis B is a prevalent global infectious disease, particularly severe in immunocompromised individuals.
- HIV/HBV coinfection and chemotherapy increase the risk of hepatitis B virus (HBV) reactivation.
- HBV reactivation can occur even in patients negative for hepatitis B surface antigen (HBsAg) but positive for anti-HBc antibodies.
Purpose of the Study:
- To review the pathogenesis, frequency, and treatment strategies for HBV reactivation in immunocompromised patients.
- To highlight the importance of preemptive antiviral therapy in preventing HBV reactivation during immunosuppressive treatments.
- To discuss prophylaxis protocols for reducing HBV recurrence post-transplantation.
Main Methods:
- Literature review of current knowledge on HBV reactivation in immunocompromised populations.
- Analysis of treatment outcomes for highly active antiretroviral treatment (HAART) in HIV/HBV coinfection.
- Evaluation of prophylactic measures including immunoglobulins and nucleos(t)ide analogues.
Main Results:
- Highly active antiretroviral treatment (HAART) containing HBV-active substances reduces liver morbidity and mortality in HIV/HBV coinfected patients.
- Preemptive treatment with HBV polymerase inhibitors is recommended for HBsAg-positive patients, regardless of HBV DNA levels, for 12 months post-therapy.
- Combination prophylaxis with hepatitis B immunoglobulins (HBIG) and nucleos(t)ide analogues (NUC) significantly reduces HBV recurrence after transplantation (0-10%).
Conclusions:
- HBV reactivation is a serious concern in immunocompromised patients, necessitating vigilant monitoring and management.
- Early and sustained antiviral prophylaxis is essential to mitigate the risks of HBV reactivation and associated liver disease.
- Tailored treatment strategies, including HAART and preemptive therapies, are vital for improving outcomes in patients at risk of HBV reactivation.
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