Arora, Anil ; Anand, Anil C. ; Kumar, Ashish ; Singh, Shivaram P. ; Aggarwal, Rakesh ; Dhiman, Radha K. ; Aggarwal, Shyam ; Alam, Seema ; Bhaumik, Pradeep ; Dixit, Vinod K. ; Goel, Ashish ; Goswami, Bhabadev ; Kumar, Ashok ; Kumar, Manoj ; Madan, Kaushal ; Murugan, Natarajan ; Nagral, Aabha ; Puri, Amarender S. ; Rao, Padaki N. ; Saraf, Neeraj ; Saraswat, Vivek A. ; Sehgal, Sanjeev ; Sharma, Praveen ; Shenoy, Koticherry T. ; Wadhawan, Manav (2018) INASL Guidelines on Management of Hepatitis B Virus Infection in Patients receiving Chemotherapy, Biologicals, Immunosupressants, or Corticosteroids Journal of Clinical and Experimental Hepatology, 8 (4). pp. 403-431. ISSN 09736883
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Official URL: http://doi.org/10.1016/j.jceh.2018.06.010
Related URL: http://dx.doi.org/10.1016/j.jceh.2018.06.010
Abstract
Hepatitis B Virus (HBV) reactivation in patients receiving chemotherapy, biologicals, immunosupressants, or corticosteroids is emerging to be an important cause of morbidity and mortality in patients with current or prior exposure to HBV infection. These patients suffer a dual onslaught of illness: one from the primary disease for which they are receiving the culprit drug that led to HBV reactivation, and the other from HBV reactivation itself. The HBV reactivation not only leads to a compromised liver function, which may culminate into hepatic failure; it also adversely impacts the treatment outcome of the primary illness. Hence, identification of patients at risk of reactivation before starting these drugs, and starting treatment aimed at prevention of HBV reactivation is the best strategy of managing these patients. There are no Indian guidelines on management of HBV infection in patients receiving chemotherapy, biologicals, immunosupressants, or corticosteroids for the treatment of rheumatologic conditions, malignancies, inflammatory bowel disease, dermatologic conditions, or solid-organ or bone marrow transplantation. The Indian National Association for Study of the Liver (INASL) had set up a taskforce on HBV in 2016, with a mandate to develop consensus guidelines for management of various aspects of HBV infection, relevant to India. In 2017 the taskforce had published the first INASL guidelines on management of HBV infection in India. In the present guidelines, which are in continuation with the previous guidelines, the issues on management of HBV infection in patients receiving chemotherapy, biologicals, immunosupressants, or corticosteroids are addressed.
Item Type: | Article |
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Source: | Copyright of this article belongs to Elsevier Inc. |
Keywords: | ACLF, Acute-on-Chronic Liver Failure; AFP, Alphafetoprotein; ALT, Alanine Aminotransferase; Anti-HBc, Antibodies to Hepatitis B Core Antigen; Anti-HBs, Antibodies to Hepatitis B Surface Antigen; CHB, Chronic Hepatitis B; CHOP, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone; CKD, Chronic Kidney Disease; DILI, Drug-Induced Liver Injury; DNA, Deoxyribonucleic Acid; ETV, Entecavir; GRADE, Grading of Recommendations, Assessment, Development and Evaluation; HAV, Hepatitis A Virus; HBIG, Hepatitis B Immune Globulin; HBV DNA, Hepatitis B Virus Deoxyribonucleic Acid; HBV, Hepatitis B Virus; HBcAg, Hepatitis B Core Antigen; HBeAg, Hepatitis B Envelope Antigen; HBsAg, Hepatitis B Surface Antigen; HDV, Hepatitis D Virus; HEV, Hepatitis E Virus; HLA, Human Leukocyte Antigen Class I; INASL, Indian National Association for Study of the Liver; LAM, Lamivudine; NAs, Nucleos(t)ide Analogs; NHL, Non-Hodgkin’s Lymphoma; NK, Natural Killer; PegIFN-α, Pegylated Interferon Alpha; RA, Rheumatoid Arthritis; SLE, Systemic Lupus Erythematosus; TAF, Tenofovir Alafenamide; TDF, Tenofovir Disoproxil Fumarate; TLC, Total Leucocyte Count; ULN, Upper Limit of Normal; cancer; cccDNA, Covalently Closed Circular Deoxyribonucleic Acid; chemotherapy; hepatitis B; immunosupressants; liver failure; rcDNA, Relaxed-Circular Deoxyribonucleic Acid |
ID Code: | 129545 |
Deposited On: | 23 Nov 2022 10:57 |
Last Modified: | 23 Nov 2022 10:57 |
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