Hepatitis B virus infection and immunosuppressive therapy in patients with inflammatory bowel disease

Hepatitis B reactivation has been widely reported in patients undergoing immunosuppressive therapy in oncohaematological and transplant settings, with a high frequency of hepatic failure. This topic has received growing scientific interest and several studies reported the preventive effect of antiviral agents on hepatitis B reactivation during immunosuppression therapy. Routine prophylaxis is therefore recommended and specific recommendations were elaborated by AASLD, EASL and AISF. On the contrary, few data are available on the risk of HBV reactivation in patients with inflammatory bowel disease (IBD) receiving immunosuppressive therapy, and major questions regarding the optimal management (screening, prophylaxis, therapy, monitoring) of IBD patients with HBV infection remain to be addressed. The aim of this paper is to provide a systematic review of the literature to underline the main aspects of HBV infection and reactivation in patients affected by IBD treated with conventional or biological immunosuppressive drugs