title: Prophylaxis and treatment of hepatitis B in immunocompromised patients.
abstract: The literature on hepatitis B virus (HBV) in immunocompromised patients is heterogeneous and referred mainly to the pre-antivirals era. Today 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 hepatitis B surface antigen (HBsAg) monitoring (or universal prophylaxis, in case of high risk immunosuppression) in subjects with markers of previous contact with HBV (HBsAg negative and anti-HBc positive), in order to prevent reverse seroconversion. Moreover it is suggested a strict adherence to criteria of allocation based on the virological characteristics of both recipients and donors in the general setting of transplants and in liver transplantation the universal prophylaxis with nucleos(t)ides analogues (frequently combined with specific anti-HBV immunoglobulins) in HBsAg positive candidates and in HBsAg negative recipients of anti-HBc positive grafts.
authors: Division of Gastroenterology and Hepatology, AO San Giovanni Battista, Torino, Italy. alfredomarzano@yahoo.it
authors: A
authors: A
authors: Marzano
authors: E
authors: E
authors: Angelucci
authors: P
authors: P
authors: Andreone
authors: M
authors: M
authors: Brunetto
authors: R
authors: R
authors: Bruno
authors: P
authors: P
authors: Burra
authors: P
authors: P
authors: Caraceni
authors: B
authors: B
authors: Daniele
authors: V
authors: V
authors: Di Marco
authors: F
authors: F
authors: Fabrizi
authors: S
authors: S
authors: Fagiuoli
authors: P
authors: P
authors: Grossi
authors: P
authors: P
authors: Lampertico
authors: R
authors: R
authors: Meliconi
authors: A
authors: A
authors: Mangia
authors: M
authors: M
authors: Puoti
authors: G
authors: G
authors: Raimondo
authors: A
authors: A
authors: Smedile
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D002353:Carrier State; D006509:Hepatitis B / Q000517:prevention & control / Q000628:therapy*; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D016867:Immunocompromised Host; D016031:Liver Transplantation; D014019:Tissue Donors; D014180:Transplantation
chemical_list: D000998:Antiviral Agents; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens