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Blood, 2 April 2009, Vol. 113, No. 14, pp. 3147-3153. Prepublished online as a Blood First Edition Paper on January 14, 2009; DOI 10.1182/blood-2008-10-163493. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-10-163493v1 113/14/3147    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Liang, R. Search for Related Content PubMed PubMed Citation Articles by Liang, R. Related Collections How I Treat Free Research Articles Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  HOW I TREAT How I treat and monitor viral hepatitis B infection in patients receiving intensive immunosuppressive therapies or undergoing hematopoietic stem cell transplantation Raymond Liang1 1 Department of Medicine and Centre for Cancer Research, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Hepatitis B virus (HBV) reactivation is a serious but preventable complication of immunosuppression. Full HBV serologic profile must be obtained from all patients receiving intensive immunosuppressive therapy. In general, preemptive anti-HBV therapy is more effective than giving treatment after development of reactivation. Prompt lamivudine therapy should be given to at-risk patients who are hepatitis B surface antigen (HBsAg)–positive. It is recommended that lamivudine be continued until at least 6 months after the cessation of immunosuppression. Some patients requiring a longer duration of lamivudine therapy are at risk of developing drug resistance. The newer anti-HBV agents are effective in overcoming lamivudine resistance. Early use of these agents may be considered. HBV reactivation was observed in HBsAg-negative patients with occult HBV infection (HBV DNA-positive) who are on heavy immunosuppression. The optimal management of this group of patients is unclear. For patients receiving allogeneic HSC transplants, the HBV status of the donors requires special attention. To minimize the risk of transmission of infection to recipients, HBsAg-positive donors should receive adequate anti-HBV therapy before HSC donation. As the result of adoptive immune transfer, clearance of HBsAg is observed in HBsAg-positive patients receiving HSC transplants from donors who are positive for hepatitis B surface and core antibodies. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Treatment of viral hepatitis B infection in patients receiving intensive immunosuppressive therapies Philippe Genet, Tahar Touahri, and Veronique Morel Blood 2009 113: 6034. [Full Text] [PDF] This article has been cited by other articles: P. Genet, T. Touahri, and V. Morel Treatment of viral hepatitis B infection in patients receiving intensive immunosuppressive therapies Blood, June 4, 2009; 113(23): 6034 - 6034. [Full Text] [PDF]

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