Liver Failure by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030509835
Publisher: Springer International Publishing

5.Answer: B

American Gastroenterology Association guidelines state that patients who have HBs Antigen +/ anti-HBc positive or HBs antigen negative/anti-HBc positive serologic profiles who are being treated with TNF alpha inhibitors such as etanercept, adalimumab, certolizumab and infliximab are at moderate risk of hepatitis B reactivation (1–10% of cases) and require hepatitis B prophylaxis during treatment and for at least 6 months after stopping immunosuppression. Patients who are HBs antigen negative/anti-HBc positive are likely to have a lower reactivation rate with anti-TNF therapy as compared to patients with HBs antigen positive/anti-HBc positive serostatus, but given the paucity of data in this patient population, prophylaxis is recommended. Multiple meta-analyses have demonstrated reduced reactivation and development of virological resistance after the use of third generation nucleos(t)ide drugs such as tenofovir and entecavir over lamivudine.Reference

Reddy KR, Beavers KL, Hammond SP, et al. American Gastroenterological Association Institute Guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology 2015; 148(1): 215–19.

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