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Hepatitis B virus reactivation associated with immunosuppressive therapy

Anna SF Lok, MD
Peter A L Bonis, MD
Section Editor
Rafael Esteban, MD
Deputy Editor
Jennifer Mitty, MD, MPH


The natural course of hepatitis B virus (HBV) infection is determined through the interplay between viral replication and the host's immune response. HBV persists in the body of all patients with infection, even those with evidence of serological recovery. Thus, individuals with a history of HBV infection who receive immunosuppressive therapy are at risk for HBV reactivation and a flare of their HBV disease. This can result in increased serum aminotransferase levels, fulminant hepatic failure, and/or death [1]. In addition, reactivation of HBV can lead to an interruption of immunosuppressive therapy (eg, chemotherapy), delaying treatment of the underlying disease.

This topic review will discuss the clinical manifestations, diagnosis, management, and prevention of HBV reactivation among those receiving immunosuppressive therapy. Discussions of HBV reactivation in the setting of hepatitis C treatment, and the clinical manifestations, diagnosis, and treatment of chronic HBV infection are found elsewhere:

(See "Patient evaluation and selection for antiviral therapy for chronic hepatitis C virus infection".)

(See "Overview of the management of chronic hepatitis C virus infection".)

(See "Diagnosis of hepatitis B virus infection".)

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Literature review current through: Nov 2017. | This topic last updated: Jan 31, 2017.
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