title: Challenges in treating patients with inflammatory bowel disease and concurrent viral hepatitis infection.
abstract: Inflammatory bowel diseases (IBD) require long-term administration of immunomodulatory treatments to maintain disease remission. Due to the high worldwide prevalence of hepatitis B (HBV) or C (HCV) virus infections, presence of concurrent hepatitis can be a relevant clinical issue to manage when treating IBD. Areas covered: The paper summarizes epidemiological data about IBD and HBV/HCV infection and reviews current knowledge about the natural history of HBV and HCV in the IBD setting, concentrating on risk of hepatitis reactivation during immunosuppressive treatment. Most updated recommendations for management of HBV and HCV infections in IBD patients are discussed. Expert commentary: The development of new drugs for IBD with different molecular targets and the availability of potent and efficacious antiviral drugs for HBV and HCV will simplify management of hepatitis infection in IBD patients in the near future.
authors.affiliation: a A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology , Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano , Milan , Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Degasperi
authors.affiliation: b Department of Pathophysiology and Transplantation , Università degli Studi di Milano , Milan , Italy.|c Gastroenterology and Endoscopy Unit , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico , Milan , Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Caprioli
authors.affiliation: d Gastroenterology Specialist Registrar , St. James's Hospital , Dublin , Ireland.|e Research Fellow, School of Medicine , Trinity College Dublin , Dublin , Ireland.
authors.forename: Omar
authors.initials: O
authors.lastname: El Sherif
authors.affiliation: f Department of Molecular and Clinical Pharmacology , University of Liverpool , Liverpool , UK.
authors.forename: David
authors.initials: D
authors.lastname: Back
authors.affiliation: a A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology , Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano , Milan , Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Colombo
authors.affiliation: a A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology , Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano , Milan , Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Aghemo
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D004347:Drug Interactions; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016174:Hepacivirus / Q000187:drug effects / Q000276:immunology; D006509:Hepatitis B / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D006515:Hepatitis B virus / Q000187:drug effects / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D019338:Polypharmacy; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents
keywords: Anti-TNF; HBV; HCV; immunosuppressive treatment; inflammatory bowel diseases; viral hepatitis