caa a22 4500 44588360X CHVBK 20180317145552.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s10157-011-0464-7 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0464-7 Prevention of hepatitis B virus reactivation in immunosuppressive therapy or chemotherapy [Elektronische Daten] [Waka Ohishi, Kazuaki Chayama] In recent years, hepatitis B virus (HBV) has been found to reproliferate either during or following immunosuppressive therapy or chemotherapy, with hepatitis caused by HBV reactivation now considered a serious issue. HBV reactivation is categorized into occurrence in HBsAg- and anti-HBe-positive asymptomatic carriers, and in HBsAg-negative, anti-HBc low-titer-positive, and/or anti-HBs-positive resolved HBV infection cases. Despite the fact that "clinical cure” is claimed for such resolved HBV cases, low levels of ongoing HBV production are now recognized as being sustained within the liver or in peripheral blood mononuclear cells, with the infection thus now considered to be virologically persistent. The risk of HBV reactivation rises as the level of immunosuppression intensifies, but in recent years HBV reactivation risk has been clearly shown to increase in cases of rituximab plus steroid-containing regimen for treatment of malignant lymphoma. In particular, the incidence of fulminant hepatitis caused by HBV reactivation in cases with resolved HBV infection is reported to be higher than that brought about by acute hepatitis B. Therefore, for all cases in which immunosuppressive therapy or chemotherapy treatment regimens are used, screening for HBV infection and appropriate management in accordance with the status of HBV-related markers are crucial, aimed at preventing occurrence of HBV reactivation. The foundation of the aforementioned management, regardless of HBsAg status, is administration of nucleoside analogues, with their powerful anti-viral properties, when HBV DNA levels reach detectable levels. Japanese Society of Nephrology, 2011 Hepatitis B virus reactivation nationallicence De novo HBV infection nationallicence Steroid nationallicence Rituximab nationallicence Nucleoside analogue nationallicence Ohishi Waka Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan aut Chayama Kazuaki Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Japan aut Clinical and Experimental Nephrology Springer Japan 15/5(2011-10-01), 634-640 1342-1751 15:5<634 2011 15 10157 https://doi.org/10.1007/s10157-011-0464-7 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0464-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ohishi Waka Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan aut NATIONALLICENCE 700 1- Chayama Kazuaki Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/5(2011-10-01), 634-640 1342-1751 15:5<634 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer