scholarly journals Risk and Prevention of Hepatitis B Virus Reactivation during Immunosuppression for Non-Oncological Diseases

2021 ◽  
Vol 10 (21) ◽  
pp. 5201
Author(s):  
Lorenzo Onorato ◽  
Mariantonietta Pisaturo ◽  
Clarissa Camaioni ◽  
Pierantonio Grimaldi ◽  
Alessio Vinicio Codella ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Immunosuppressive Drugs ◽  
Hbv Reactivation ◽  
Virus Reactivation ◽  
Occult Hbv Infection ◽  
Occult Hbv ◽  
Oncological Patients ◽  
Oncological Diseases ◽  
Life Threatening ◽  
Few Data

Reactivation of overt or occult HBV infection (HBVr) is a well-known, potentially life-threatening event which can occur during the course of immunosuppressive treatments. Although it has been described mainly in subjects receiving therapy for oncological or hematological diseases, the increasing use of immunosuppressant agents in non-oncological patients observed in recent years has raised concerns about the risk of reactivation in several other settings. However, few data can be found in the literature on the occurrence of HBVr in these populations, and few clear recommendations on its management have been defined. The present paper was written to provide an overview of the risk of HBV reactivation in non-neoplastic patients treated with immunosuppressive drugs, particularly for rheumatological, gastrointestinal, dermatological and neurological diseases, and for COVID-19 patients receiving immunomodulating agents; and to discuss the potential strategies for prevention and treatment of HBVr in these settings.

scholarly journals Occult Hepatitis B Virus Infection: A Review Update

2018 ◽  
Vol 5 (1) ◽  
pp. 32-38
Author(s):  
Arifa Akram
Keyword(s):  
Dna Amplification ◽  
Epidemiological Data ◽  
Diagnostic Techniques ◽  
Hbv Dna ◽  
Detection Methods ◽  
Current Evidence ◽  
Hbv Reactivation ◽  
Occult Hbv Infection ◽  
Occult Hepatitis ◽  
Occult Hbv

Occult HBV infection (OBI) is defined as HBV DNA detection in serum or in the liver by sensitive diagnostic tests in HbsAg negative individuals with or without serologic markers of previous viral exposure. Since OBI was first described in the late 1970s, there has been increasing concern in this topic. OBI can be both a source of virus contamination in blood and organ donations and the reservoir for full blown hepatitis after reactivation. HBV reactivation depends on viral and host factors but these associations have not been analyzed thoroughly. Although the exact mechanism of OBI yet not proved, intrahepatic persistence of viral covalently closed circular DNA under the host’s strong immune suppression of HBV replication and gene expression seems to be a cause. Current evidence suggests that OBI can favour the progression of fibrosis, cirrhosis, hepatocellular carcinoma and post transfusion hepatitis (PTH). Epidemiological data regarding the global prevalence of OBI vary due to the use of detection methods of different sensitivity and specificity. Appropriate diagnostic techniques must be adopted. Sensitive HBV DNA amplification assay is the gold standard assay for detection of OBI.Bangladesh Journal of Infectious Diseases 2018;5(1):32-38

scholarly journals Neurobiological Impact of EMDR in Cancer

2016 ◽  
Vol 10 (3) ◽  
pp. 153-161 ◽  
Author(s):  
Sara Carletto ◽  
Marco Pagani
Keyword(s):  
Stress Disorder ◽  
Brain Structures ◽  
Traumatic Experience ◽  
Patients With Cancer ◽  
Posttraumatic Symptoms ◽  
Clinical Level ◽  
Oncological Patients ◽  
Oncological Diseases ◽  
Life Threatening ◽  
Different Populations

The exposure to a life-threatening disease such as cancer may constitute a traumatic experience that in some cases may lead to the development of posttraumatic stress disorder (PTSD). In recent years, several studies investigated this syndrome in patients with cancer, but few focused on the underlying neurobiology. The aim of this work was to review the current literature of neurobiology of PTSD in oncological diseases, focusing on a comparison with the results of neurobiological studies on PTSD in non-oncological patients and on treatments resulted effective for such disorder. Brain structures having a role in the appearance of PTSD in psycho-oncology, and in particular, in intrusive symptoms, seem to be the same involved in non-oncologic PTSD. These findings may have important implications also at clinical level, suggesting that psychotherapies found to be effective to treat PTSD in different populations may be offered also to patients with cancer-induced posttraumatic symptoms. Further studies are needed to deepen our knowledge about cancer-related PTSD neurobiology and its treatment, aiming at transferring the results into clinical practice.

scholarly journals Occult Hepatitis B: Clinical Viewpoint and Management

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Mehdi Zobeiri
Keyword(s):  
Hbv Dna ◽  
Hbv Infection ◽  
Host Factors ◽  
Hbv Reactivation ◽  
Occult Hbv Infection ◽  
Occult Hepatitis ◽  
Occult Hbv ◽  
Occult Hepatitis B ◽  
Routine Prophylaxis ◽  
Organ Donations

Occult HBV infection (OBI) is defined as HBV DNA detection in serum or in the liver by sensitive diagnostic tests in HBsAg-negative patients with or without serologic markers of previous viral exposure. OBI seems to be higher among subjects at high risk for HBV infection and with liver disease. OBI can be both a source of virus contamination in blood and organ donations and the reservoir for full blown hepatitis after reactivation. HBV reactivation depends on viral and host factors but these associations have not been analyzed thoroughly. In OBI, it would be best to prevent HBV reactivation which inhibits the development of hepatitis and subsequent mortality. In diverse cases with insufficient data to recommend routine prophylaxis, early identification of virologic reactivation is essential to start antiviral therapy. For retrieving articles regarding OBI, various databases, including OVID, PubMed, Scopus, and ScienceDirect, were used.

scholarly journals Infectious Complications of Multiple Sclerosis Therapies: Implications for Screening, Prophylaxis, and Management

2018 ◽  
Vol 5 (8) ◽  
Author(s):  
David J Epstein ◽  
Jeffrey Dunn ◽  
Stan Deresinski
Keyword(s):  
Multiple Sclerosis ◽  
Opportunistic Infections ◽  
Latent Tuberculosis ◽  
Immunosuppressive Drugs ◽  
Infectious Complications ◽  
Hbv Reactivation ◽  
Virus Reactivation ◽  
Oral Agents ◽  
Increased Risk ◽  
Substantial Risk

Abstract Multiple sclerosis therapies include interferons, glatiramer, and multiple immunosuppressive drugs. Discerning infectious risks of immunosuppressive drugs requires understanding their mechanisms of action and analyzing interventional studies and postmarketing observational data. Though identical immunosuppressive therapies are sometimes used in non-neurologic conditions, infectious risks may differ in this population. Screening for and treatment of latent tuberculosis (TB) infection should be prioritized for patients receiving alemtuzumab; ocrelizumab is likely not associated with an increased risk of TB. Hepatitis B virus (HBV) reactivation can be devastating for patients treated with ocrelizumab and alemtuzumab, whereas the small molecule oral agents do not likely pose substantial risk of HBV. Progressive multifocal leukoencephalopathy is a particular concern with natalizumab. Alemtuzumab, and possibly natalizumab and fingolimod, risks herpes virus reactivation and may warrant prophylaxis. Unusual opportunistic infections have been described. Vaccination is an important tool in preventing infections, though vaccine timing and contraindications can be complex.

scholarly journals Hematological Malignancies and HBV Reactivation Risk: Suggestions for Clinical Management

Viruses ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 858 ◽  
Author(s):  
Alessandra Zannella ◽  
Massimo Marignani ◽  
Paola Begini
Keyword(s):  
Hematological Malignancies ◽  
Management Strategies ◽  
Clinical History ◽  
Immunosuppressive Drugs ◽  
Viral Reactivation ◽  
Current Evidence ◽  
Hbv Reactivation ◽  
Virus Reactivation ◽  
Effective Prevention ◽  
Clinical Consequences

It is well known that hepatitis B virus reactivation (HBVr) can occur among patients undergoing treatment for hematological malignancies (HM). The evaluation of HBVr risk in patients undergoing immunosuppressive treatments is a multidimensional process, which includes conducting an accurate clinical history and physical examination, consideration of the virological categories, of the medication chosen to treat these hematological malignancies and the degree of immunosuppression induced. Once the risk of reactivation has been defined, it is crucial to adopt adequate management strategies (should reactivation occur). The purpose of treatment is to prevent dire clinical consequences of HBVr such as acute/fulminant hepatitis, and liver failure. Treatment will be instituted according to the indications and evidence provided by current international recommendations and to prevent interruption of lifesaving anti-neoplastic treatments. In this paper, we will present the available data regarding the risk of HBVr in this special population of immunosuppressed patients and explore the relevance of effective prevention and management of this potentially life-threatening event. A computerized literature search was performed using appropriate terms to discover relevant articles. Current evidence supports the policy of universal HBV testing of patients scheduled to undergo treatment for hematological malignancies, and clinicians should be aware of the inherent risk of viral reactivation among the different virological categories and classes of immunosuppressive drugs.

scholarly journals Recent Advances in HBV Reactivation Research

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Lixia Guo ◽  
Dan Wang ◽  
Xiping Ouyang ◽  
Ni Tang ◽  
Xuemei Chen ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Public Health Problem ◽  
Future Research ◽  
Hbv Reactivation ◽  
Targeted Drugs ◽  
Occult Hbv Infection ◽  
Important Public Health Problem ◽  
Important Public Health ◽  
Occult Hbv ◽  
B Virus

Hepatitis B virus (HBV) is an important public health problem that poses a serious threat to human health. HBV reactivation generally occurs in overt or occult HBV infection patients who suffered DDAs, chemotherapy, or immunosuppressive therapy, especially when some solid tumors and leukemia patients are using hormones such as prednisolone and imatinib. The approximate incidence of HBV reactivation ranged from about 10% to 40%. Scientists often explore the molecular mechanisms from both the virus and the host. But some studies have reported that some drugs (cisplatin, rituximab, imatinib, and glucocorticoid) could induce HBV reactivation directly. However, the specific molecular mechanisms were unclear. With the emergence of new antiviral drugs and molecular targeted drugs, the risk of HBV reactivation will increase significantly. Therefore this review was expected to be used to provide recommendations for future research in HBV reactivation.

scholarly journals Hematological Malignancies and HBV Reactivation: Suggestions for Clinical Management

2019 ◽  
Author(s):  
Alessandra Zannella ◽  
Massimo Marignani ◽  
Paola Begini
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hematological Malignancies ◽  
Immunosuppressive Drugs ◽  
Viral Reactivation ◽  
Hbv Reactivation ◽  
Virus Reactivation ◽  
Hepatitis B Virus Reactivation ◽  
B Virus ◽  
Clinical Consequences

It is well known that the event of hepatitis B virus reactivation can occur among patients undergoing treatment for hematological malignancies. In this paper we will present the available data regarding the risk of hepatitis B virus reactivation in this special population of immunosuppressed patients and explore the relevance of an accurate prevention and management of this condition. A computerized literature search was performed using appropriate terms arrangement, including English-written literature only or additional relevant articles. The evaluation of hepatitis B reactivation risk is a multidimensional process, which includes conducting an accurate clinical and physical history, considering the virological categories, the knowledge of the medication chosen to treat these hematological malignancies and the induced grade of immunosuppression. Adopting adequate preventive strategies and surveillance according to the current international recommendations is crucial to prevent HBVr and its dire clinical consequences (hepatitis, liver failure, interruption of lifesaving anti-neoplastic treatments). Universal HBV screening of patients scheduled to undergo treatment for hematological malignancies should be the chosen policy, and clinicians should be aware of the inherent risk of viral reactivation among the different virological categories and the classes of immunosuppressive drugs.

scholarly journals Occult HBV Infection: A Case Series at a Military Treatment Facility

2019 ◽  
Vol 185 (5-6) ◽  
pp. e795-e798
Author(s):  
Kevin Pak ◽  
Sarah Ordway ◽  
Dawn Torres
Keyword(s):  
Hepatitis B ◽  
Case Series ◽  
The United States ◽  
Hbv Infection ◽  
Hbv Reactivation ◽  
Treatment Facility ◽  
Occult Hbv Infection ◽  
Occult Hbv ◽  
Male Patients ◽  
Military Treatment Facility

Abstract Occult HBV infection (OBI) is defined as the presence of detectable hepatitis B virus (HBV) DNA in HBV surface antigen (HBsAg) negative individuals. Rarely, OBI is attributed to mutant HBV that cannot be detected by commercial assays, but most cases occur in the setting of chronic hepatitis B, particularly infection with wild-type viruses associated with strong HBV suppression. OBI is a high-risk diagnosis as it is associated with multiple complications: HBV reactivation in immunocompromised states, transmission of HBV, progression of liver disease, and hepatocellular carcinoma. The diagnosis is also easy to overlook, as the negative HBsAg in such cases can be falsely reassuring. This case series describes four male patients (mean age 51) who were diagnosed with OBI in the same military treatment facility between February 2018 and October 2018. Two of the four patients were active duty service members at the time of diagnosis. These patients had variable clinical presentations and outcomes. This case series illustrates the clinical significance of OBI and the importance of screening for OBI in HBsAg negative patients with signs of chronic or severe hepatic inflammation. It also prompts an intriguing question regarding the prevalence of both HBV and OBI in the United States military and whether or not routine screening for HBV should be implemented in this population. Further study is warranted to determine if adding HBV core antibody to a universally employed screening regimen would be beneficial.

HBV reactivation in CLL patients with occult HBV infection treated with ibrutinib without viral prophylaxis

2019 ◽  
Vol 60 (5) ◽  
pp. 1340-1342 ◽  
Author(s):  
Idanna Innocenti ◽  
Francesca Morelli ◽  
Francesco Autore ◽  
Andrea Corbingi ◽  
Raffaella Pasquale ◽  
...  
Keyword(s):  
Hbv Infection ◽  
Hbv Reactivation ◽  
Occult Hbv Infection ◽  
Occult Hbv
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