In patients with rheumatic diseases undergoing immunosuppressive treatment, hepatitis B virus reactivation (HBVr) has been long recognized as a major treatment-related adverse event with substantial morbidity and mortality. Because HBVr is easily preventable with appropriate screening and monitoring strategies, and, when indicated, prophylactic antiviral treatment, awareness of this complication is of the utmost importance, especially in the era of biologic treatments. As a condition, it continues to be topical, in view of the emergence of novel classes of immunosuppressive drugs (i.e. Janus kinase inhibitors) acquiring licenses for a variety of rheumatic diseases. The class-specific risk of these agents for HBVr has not yet been determined. Moreover, ambiguity still exists for the management of patients planned to be treated with traditional agents, such as cyclophosphamide and glucocorticoids, particularly in the setting of resolved HBV infection. Clinicians in the field of rheumatic diseases should be tailoring their practice according to the host's profile and treatment-specific risk for HBVr. In this review, the authors attempt to critically review the existing literature and provide practical advice on these issues.

中文翻译：

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在风湿性疾病中重新激活乙型肝炎病毒感染：风险和管理方面的考虑。

在风湿性疾病接受免疫抑制治疗的患者中，乙肝病毒再激活（HBVr）长期以来一直被认为是与治疗有关的主要不良事件，具有较高的发病率和死亡率。由于可以通过适当的筛查和监测策略以及预防性抗病毒治疗轻松预防HBVr，因此，特别是在生物治疗时代，对这种并发症的认识至关重要。作为一种情况，鉴于新型免疫抑制药物（即Janus激酶抑制剂）的出现，它仍然是热门话题，该药物获得了针对各种风湿性疾病的许可。这些药物对HBVr的特定类别风险尚未确定。此外，对于计划用传统药物（例如环磷酰胺和糖皮质激素）治疗的患者的管理仍存在歧义，特别是在解决HBV感染的情况下。风湿性疾病领域的临床医生应根据宿主的概况和特定于治疗的HBVr风险调整自己的做法。在这篇综述中，作者试图批判性地回顾现有文献并就这些问题提供实用建议。