HBV reactivation in immunosuppressed patients

Background: Reactivation of hepatitis B virus (HBV) is an important complication of immunosuppressive therapies. The aim of our study was to retrospectively evaluate the clinical and epidemiological features, as well as the outcome, of a cohort of patients with HBV infection undergoing immunosuppressive therapy in the period between January 2009 and November 2013. — Patients and Methods: We evaluated the clinical and epidemiological characteristics of two groups of patients: 45 patients were identified as HBV positive before immunosuppression and, therefore, treated with antiviral prophylaxis or therapy (Group A). 22 patients were identified as HBV-positive during or after immunosuppression (Group B) — Results: We evaluated 67 patients: 43 males (64.2%) and 24 females (35.8%), median age 62 (interquartile range 48-68) years. 61 patients were Italian (91%), 4 Chinese (5.9%) and 2 Romanian (2.9%). Hematologic malignancies were the most common diseases in both groups (73% in group A and 50% in group B, respectively). HBV reactivation occurred only in patients who were not treated by either prophylaxis or therapy. They all required anti-HBV therapy, which led to HBV suppression in all cases. — Conclusions: Our work emphasizes the importance of HBV screening and eventually prophylaxis/therapy in patients undergoing immunosuppressive therapies to prevent potential reactivations and even fatal consequences.