Screening and Prophylaxis to Prevent Hepatitis B Reactivation: Introduction and Immunology

Key points

Background

In 4 articles in this issue, we present a consensus statement that was conceived in response to the large unmet need for guidelines for the management of hepatitis B virus (HBV) infection in the setting of immunosuppression. Current recommendations are limited, with nearly all guidelines focused on hematological malignancies and, to a lesser extent, some solid tumors. Few of the guidelines address the wider range of other immunosuppressive states in which reactivation may occur, including those

Immunology of reactivation of hepatitis B: roles of innate and adaptive immunity

Innate immunity, the body’s nonspecific immune system, normally provides an immediate defense in the presence of infection. However, some pathogenic microbes such as the HBV virus have learned to bypass aspects of the innate immune system. Adaptive immunity is more specific than innate immunity and is activated by exposure to an antigen, with the stimulation of lymphocytes, T cells, and B cells (Fig. 1). In adaptive immunity, CD4⁺ T (helper) cells activate macrophages, cytotoxic T cells, and B

Recommendations for screening and prophylaxis to prevent hepatitis B reactivation

In the following articles in this issue, we provide specific recommendations for preventing hepatitis B reactivation in various populations based on the most recent data or, where data are limited or missing, on expert opinion: Joe Sasadeusz and colleagues' article, “Screening and Prophylaxis to Prevent Hepatitis B Reactivation: Patients with Hematological and Solid Tumor Malignancies”, Joe Sasadeusz and colleagues' article, “Screening and Prophylaxis to Prevent Hepatitis B Reactivation:

Acknowledgments

Meetings to discuss and develop recommendations presented in this manuscript and medical writing services provided in the preparation of this manuscript were funded by Gilead Sciences. Neither the medical writer or Gilead in any way influenced the content or the conclusions of the position paper. None of the authors had any direct financial support from Gilead Sciences or any other companies.