美国胃肠病协会关于免疫抑制药物治疗中乙肝病毒再激活的预防和治疗指南

HBVr after immunosuppressive therapy is associated with significant morbidity and mortality. It is well recognized that this is a preventable consequence of hepatitis B infection. Although the definition of HBVr has varied in the literature, it is desirable to prevent the end clinical manifestation of hepatic decompensation or acute liver failure. A spectrum of serological patterns indicates ongoing or recovered hepatitis B virus (HBV) infection, and the risk of HBVr among patients presenting with these serological patterns varies depending on the type of immunosuppression. Several aspects of HBVr prevention remain unclear, including the optimal population to screen, in whom to use prophylaxis with HBV therapeutic agents, the best specific therapeutic agent to use, the duration of prophylaxis, and the type and duration of monitoring if prophylaxis is not used in those at risk. The technical review and guideline are an effort to help investigators and practicing medical providers in addressing the key areas in HBVr. The technical review and guideline have not addressed the issue of flares of chronic HBV infection over time, HBVr in coinfection with human immunodeficiency virus, and HBVr in solid organ transplantation or hematopoietic stem cell transplantation.

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