title: Hepatitis B virus infection: pathogenesis, reactivation and management in hematopoietic stem cell transplant recipients.
abstract: Hepatitis B virus (HBV) is a partially double stranded DNA virus that can integrate into host cell chromosomes as covalently closed circular DNA forms. HBV reactivation following hematopoietic stem cell transplantation in recipients with evidence of past HBV exposure, as well as exacerbation of a current HBV infection in HBV carrier recipients, secondary to chemotherapy and post-transplant immunosuppression that affect both humoral and cell-mediated control of HBV infection, are well documented in the literature. Management options include HBV-DNA screening and antiviral prophylaxis. Nucleos(t)ide analogues have been used at the start of chemotherapy and pretransplantation, with the course continuing for 6 months. However, depending on the serum HBV-DNA level, the antiviral agent might be given until a therapeutic end point is reached.
authors.affiliation: Health Protection Agency Microbiology Services-Newcastle Laboratory, Specialist Virology Centre, Newcastle, UK. samuel.moses@nhs.net
authors.forename: Samuel E
authors.initials: SE
authors.lastname: Moses
authors.forename: ZiYi
authors.initials: Z
authors.lastname: Lim
authors.forename: Mark A
authors.initials: MA
authors.lastname: Zuckerman
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000821:virology; D004279:DNA, Viral / Q000097:blood; D019468:Disease Management; D004334:Drug Administration Schedule; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006509:Hepatitis B / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007165:Immunosuppression Therapy / Q000009:adverse effects; D019259:Lamivudine / Q000008:administration & dosage* / Q000627:therapeutic use; D009894:Opportunistic Infections / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology / Q000821:virology; D019172:Transplantation Conditioning / Q000379:methods*; D014775:Virus Activation / Q000187:drug effects; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine