https://www.ncbi.nlm.nih.gov/pubmed/31977956
J Pediatr Gastroenterol Nutr. 2020 Jan 21. doi: 10.1097/MPG.0000000000002628. [Epub ahead of print]
Management of HBV Infection and Prevention of HBV Reactivation in Children with Acquired Immunodeficiencies or Undergoing Immune Suppressive, Cytotoxic or Biological Modifier Therapies.
Indolfi G1, Abdel-Hady M2, Bansal S3, Debray D4, Smets F5, Czubkowski P6, van der Woerd W7, Samyn M3, Jahnel J8, Gupte G9, Zellos A10, Mozer-Glassberg Y11, Verkade HJ12, Sokal E13, Fischler B14.
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Abstract
Reactivation of hepatitis B virus (HBV) is a known complication of immune suppressive, cytotoxic and biological modifier therapies in patients currently infected with HBV or who have had past exposure to HBV. Nowadays, newer and emerging forms of targeted biologic therapies are available for the management of rheumatologic conditions, malignancies, inflammatory bowel disease, dermatologic conditions and solid-organ, bone marrow or haematologic stem cell transplant but there is currently a lack of a systematic approach to the care of patients with or at risk of HBV reactivation. The Hepatology Committee of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) together with a working group of ESPGHAN members with clinical and research expertise in viral hepatitis developed an evidence-based position paper on reactivation of HBV infection in children identifying pertinent issues addressing the diagnosis, prevention and treatment of this condition. Relevant clinical questions were formulated and agreed upon by all the members of the working group. Questions were answered and positions were based on evidence resulting from a systematic literature search on PubMed and Embase from their inception to July, 1, 2019. A document was produced and the working group and ESPGHAN Hepatology Committee members voted on each recommendation, using a formal voting technique. A recommendation was accepted provided upon agreement by at least 75% of the working group members. This position paper provides a comprehensive update on the diagnosis, prevention and treatment of HBV reactivation in children.