title: Reactivation of occult hepatitis B virus infection in patients with rheumatic diseases: pathogenesis, risk assessment and prevention.
abstract: Over the past decade, reactivation of occult hepatitis B virus (HBV) infection has garnered much attention from rheumatologists owing to a number of reports which have indicated the potential risk of biologics in causing this previously ignored infectious complication. Hepatitis due to reactivation of occult HBV infection occurs only occasionally but with high mortality upon occurrence, placing us in a clinical dilemma "to address or not to address?" In this review, we discuss how biological and other immunosuppressive therapies increase the risk of developing reactivation of occult HBV infection and attempt to solve this clinical quandary.
authors.affiliation: Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University, N15W7, Kita-Ku, Sapporo, 060-8638, Japan. ktmasaru@med.hokudai.ac.jp.
authors.forename: Masaru
authors.initials: M
authors.lastname: Kato
authors.affiliation: Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University, N15W7, Kita-Ku, Sapporo, 060-8638, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Atsumi
mesh_terms: D006509:Hepatitis B / Q000139:chemically induced / Q000821:virology*; D006515:Hepatitis B virus; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D012216:Rheumatic Diseases / Q000188:drug therapy*; D018570:Risk Assessment; D014775:Virus Activation / Q000187:drug effects*
chemical_list: D007166:Immunosuppressive Agents
keywords: Biologics; Hepatitis B virus reactivation; Immunosuppressive drugs; Occult hepatitis B virus infection; Rheumatic diseases