title: Hepatitis B Reactivation in Rheumatic Diseases: Screening and Prevention.
abstract: Hepatitis B virus (HBV) reactivation (HBVr) has been an increasingly recognized and appreciated risk of immunosuppressive therapies in rheumatic patients. Despite its potential for significant morbidity and mortality, HBVr is a fully preventable complication with appropriate pretreatment screening and close monitoring of susceptible patients. Better knowledge of the risk for HBVr with the different antirheumatic agents and the establishment of the new-generation oral antivirals in clinical practice has greatly improved the design of screening and therapeutic algorithms. In this review, all available data regarding HBVr in rheumatic patients are critically presented and a screening and therapeutic algorithm is proposed.
authors.affiliation: Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens School of Medicine, Hippokration General Hospital, 114 Vass, Sophias Avenue, Athens 115 27, Greece; Department of Rheumatology, The Dudley Group NHS Foundation Trust, Russells Hall Hospital, Pensnett Road, Dudley DY1 2HQ, West Midlands, UK.
authors.forename: Christos
authors.initials: C
authors.lastname: Koutsianas
authors.affiliation: Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens School of Medicine, Hippokration General Hospital, 114 Vass, Sophias Avenue, Athens 115 27, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Thomas
authors.affiliation: Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens School of Medicine, Hippokration General Hospital, 114 Vass, Sophias Avenue, Athens 115 27, Greece. Electronic address: dvassilop@med.uoa.gr.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vassilopoulos
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008403:Mass Screening; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000276:immunology; D014775:Virus Activation
chemical_list: D018501:Antirheumatic Agents; D000998:Antiviral Agents; D007166:Immunosuppressive Agents
keywords: Abatacept; Biologics; Disease-modifying antirheumatic drugs; Hepatitis B; Reactivation; Rheumatic diseases; Rituximab; TNF inhibitors; Tocilizumab