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Reactivated hepatitis B due to medical interventions: the clinical spectrum expands
1Hepatology Division, Baylor University Medical Center, Dallas, TX, USA. roberper@baylorhealth.edu
Reactivated hepatitis B is a potentially serious disorder that can result in liver failure and death. It has been described with a wide variety of immunosuppressive interventions, such as cancer chemotherapy, anti-rejection drugs and the use of tumour necrosis factor-α inhibitors and monoclonal antibody to B-cell antigen. It now appears reasonable to consider transarterial chemoembolization (TAC) for hepatocellular carcinoma as an additional medical intervention associated with hepatitis B reactivation. Pre-emptive antiviral treatment of hepatitis B surface antigen (HBsAg) carriers can prevent serious complications arising from immunosuppressive-induced viral reactivation. Specific recommendations for antiviral prophylaxis in HBsAg carriers undergoing TAC should be added to international management guidelines.
Reactivated hepatitis B is a potentially serious disorder that can result in liver failure and death. It has been described with a wide variety of immunosuppressive interventions, such as cancer chemotherapy, anti-rejection drugs and the use of tumour necrosis factor-α inhibitors and monoclonal antibody to B-cell antigen. It now appears reasonable to consider transarterial chemoembolization (TAC) for hepatocellular carcinoma as an additional medical intervention associated with hepatitis B reactivation. Pre-emptive antiviral treatment of hepatitis B surface antigen (HBsAg) carriers can prevent serious complications arising from immunosuppressive-induced viral reactivation. Specific recommendations for antiviral prophylaxis in HBsAg carriers undergoing TAC should be added to international management guidelines.
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