Background & Aim

Hepatitis B reactivation related to the use of immunosuppressive therapy remains a major cause of liver-related morbidity and mortality in hepatitis B endemic Asia-Pacific region. This clinical practice guidelines aim to assist clinicians in all disciplines involved in the use of immunosuppressive therapy to effectively prevent and manage hepatitis B reactivation.

Methods

All publications related to hepatitis B reactivation with the use of immunosuppressive therapy since 1975 were reviewed. Advice from key opinion leaders in member countries/administrative regions of Asian-Pacific Association for the study of the liver was collected and synchronized. Immunosuppressive therapy was risk-stratified according to its reported rate of hepatitis B reactivation.

Recommendations

We recommend the necessity to screen all patients for hepatitis B prior to the initiation of immunosuppressive therapy and to administer pre-emptive nucleos(t)ide analogues to those patients with a substantial risk of hepatitis and acute-on-chronic liver failure due to hepatitis B reactivation.

中文翻译：

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APASL 与使用免疫抑制治疗相关的乙型肝炎再激活临床实践指南

背景与目标

在乙型肝炎流行的亚太地区，与使用免疫抑制治疗相关的乙型肝炎再激活仍然是肝脏相关发病率和死亡率的主要原因。本临床实践指南旨在帮助所有涉及使用免疫抑制疗法的临床医生有效预防和管理乙型肝炎再激活。

方法

回顾了自 1975 年以来与使用免疫抑制疗法再激活乙型肝炎相关的所有出版物。收集并同步亚太协会成员国/行政区域主要意见领袖对肝脏研究的建议。免疫抑制治疗根据其报告的乙型肝炎再激活率进行风险分层。

建议

我们建议有必要在开始免疫抑制治疗之前对所有患者进行乙型肝炎筛查，并对那些具有重大肝炎风险和因肝炎引起的慢加急性肝功能衰竭的患者预先给予核苷（酸）类似物。 B 重新激活。