Table of Contents

HK J Paediatr (New Series)
Vol 26. No. 4, 2021

HK J Paediatr (New Series) 2021;26:245-253

Contemporary Practice in Paediatrics

Recommendations in the Prevention and Management of Hepatitis B Reactivation in Paediatric Patients Receiving Immunosuppressive Therapy in Hong Kong Special Administrative Region, China

WH Chan, MYW Kwan, DC Lung, WKY Chan, MC Chan, FWT Cheng, CM Chow, ACH Ho, TL Ku, WM Lai, DWY Mak, CH Ng, FMH Poon, SMY Wong, RMS Wong, SN Wong, EKC Yau, HLY Chan, MH Chang, JF Wu, XB Xie, YL Lau, KC Chan


Hepatitis B reactivation can be a fatal complication of paediatric hepatitis B patients receiving immunosuppressive therapy. However, there is no specific recommendation in paediatric patient group. This article aims to summarize the paediatric recommendations from international guidelines with reference to Hong Kong SAR paediatric data. Hepatitis B reactivation risk is stratified into "high risk group", "moderate risk group" and "low risk group". All paediatric patients who will receive immunosuppressive therapy in moderate and high risk groups should be tested for hepatitis B surface antigen and antibody to hepatitis B core antigen prior to receiving treatment. Hepatitis B deoxyribonucleic acid (HBV DNA) level should be checked if the patients' either test is positive. Antiviral prophylaxis should be given in high risk group patients. Antiviral prophylaxis should be considered in moderate risk group patients. Hepatitis B screening tests and antiviral prophylaxis are not recommended in low risk group. Entecavir and Tenofovir disoproxil fumarate are drugs of choice.

Keyword : HBV reactivation; Immunosuppressive therapy; Paediatric


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