Related Experiment Video
Updated: Jun 14, 2026
10:37
Analysis of HBV-Specific CD4 T-cell Responses and Identification of HLA-DR-Restricted CD4 T-Cell Epitopes Based on a Peptide Matrix
Published on: October 20, 2021
Hepatitis B Virus Reactivation Risk With IL-17, IL-23/IL-12, or JAK Inhibitors: A Systematic Review and Meta-Analysis
Marouf Alhalabi1, Hussam Aldeen Alshiekh2
1Gastroenterology Department of Damascus Hospital, Ministry of Health, Damascus, Syria.
Summary
Hepatitis B virus reactivation (HBVr) is a significant risk for HBsAg-positive patients on JAK or IL-17 inhibitors. Reactivation is uncommon in anti-HBc positive individuals, especially those with anti-HBs antibodies.
Area of Science:
- Immunology
- Hepatology
- Pharmacology
Background:
- Hepatitis B virus reactivation (HBVr) is a concern in patients with chronic or occult HBV infection undergoing immunosuppressive therapy.
- Certain targeted therapies, including IL-12/23, IL-23, IL-17, and JAK inhibitors, may increase the risk of HBVr.
- Antiviral prophylaxis is often used, but its necessity based on patient serostatus requires further investigation.
Purpose of the Study:
- To determine the incidence of HBVr in patients with chronic or occult HBV infection treated with specific immunomodulatory agents without antiviral prophylaxis.
- To assess if the risk of HBVr differs based on anti-HBs antibody status in anti-HBc positive individuals.
Main Methods:
- A systematic review and meta-analysis were performed adhering to PRISMA and MOOSE guidelines.
- Data from 29 studies involving 912 patients were analyzed.
- Incidence rates and odds ratios for HBVr were calculated using generalized linear mixed-effects models.
Main Results:
- In HBsAg-positive patients, HBVr incidence was highest with JAK inhibitors (40%), followed by IL-17 (28%), and IL-12/23 or IL-23 inhibitors (10%).
- Among HBsAg-negative/anti-HBc positive patients, HBVr risk was low (1%-4%).
- Anti-HBs negativity showed a non-significant trend towards increased HBVr risk (OR 1.13).
Conclusions:
- HBVr poses a substantial risk for HBsAg-positive patients treated with JAK or IL-17 inhibitors.
- HBVr is uncommon in anti-HBc positive individuals, particularly those with anti-HBs antibodies.
- Risk stratification based on serostatus and individualized prophylaxis are recommended.
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