MANAGEMENT OF HBV INFECTION DURING IMMUNOSUPPRESIVE TREATMENT

• Main Author: Alfredo Marzano
• Format: Article
• Language: English
• Published: PAGEPress Publications 2009-11-01
• Series: Mediterranean Journal of Hematology and Infectious Diseases
• Subjects: Hepatitis, Immunosuppression, Antiviral Therapy, Lamivudine,
• Online Access: http://www.mjhid.org/article/view/5226

<p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 200%; text-autospace: ideograph-numeric; text-align: justify;"><span style="mso-ansi-language: EN-US; mso-fareast-font-family: Helvetica;" lang="EN-US"><span style="font-size: small;"><span style="font-family: Times New Roman;">The literature on hepatitis B virus (HBV) in immunocompromised patients is heterogeneous and refers mainly to the pre-antivirals era. Currently, a rational approach to the problem of hepatitis B in these patients provides for: a) the evaluation of HBV markers and of liver condition in all subjects starting immunosuppressive therapies (baseline), b) the treatment with antivirals (therapy) of active carriers, c) the pre-emptive use of antivirals (prophylaxis) in inactive carriers, especially if they are undergoing immunosuppressive therapies judged to be at high risk, d) the biochemical and HBsAg monitoring (or universal prophylaxis in case of high risk immunosuppression, as in onco-haematologic patients and bone marrow transplantation) in subjects with markers of previous contact with HBV (HBsAg-negative and antiHBc-positive), in order to prevent reverse seroconversion.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 200%; text-autospace: ideograph-numeric; text-align: justify;"><span style="mso-ansi-language: EN-US; mso-fareast-font-family: Helvetica;" lang="EN-US"><span style="font-size: small;"><span style="font-family: Times New Roman;">Moreover in solid organ transplants it is suggested a strict adherence to the criteria of allocation based on the virological characteristics of both recipients and donors<span style="mso-spacerun: yes;">  </span>and the universal prophylaxis or therapy with nucleos(t)ides analogs</span></span></span></p>