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- W2768461013 abstract "a very strict adherence to the definitions of the different stages of chronic HBV infection, aimed at: (1) distinguishing the presence of a pre-existing significant damage of the liver, in order to quantify the risk of clinical decompensation at the time of HBV relapse; (2) defining the condition of active and inactive carriers in overt infection and of potential occult infection in the specific setting of immunosuppression, in order to define the risk and the best preventive or therapeutic strategy; (3) assessing the definitions of the clinical and virological events; (4) proposing criteria for monitoring. The structure of the document is absolutely in accordance with the special article by Thomas. These definitions and the network of communication and discussion between different specialists involved in these conferences have led to the development of a rational approach to the problem of hepatitis B in immunocompromised patients, which provides for: (1) monitoring the markers of the HBV in all subjects starting immunosuppressive therapies and the evaluation of their liver condition (baseline), (2) therapy of active carriers with nucleos(t)ide analogues, (3) prophylaxis of inactive carriers with antivirals in the most part of cases, especially if they are undergoing immunosuppressive therapies judged to be at high risk, (4) biochemical and HBsAg monitoring (or viremia monitoring, when this strategy is chosen), with the aim of activating a swift therapy or a targeted prophylaxis in inactive or occult carriers at the time of viral reactivation or HBsAg sero-reversion, respectively. The similar approach confirms, in our opinion, the role of the EVHEI statements and of the joint action and co-operation proposed by Thomas, not only for the best therapy of chronic hepatitis B but also, and particularly, for the best treatment in the setting of immunosuppression, which is becoming a very important context due to the considerable number of patients potentially involved and of different specialists interested in the problem. References" @default.
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- W2768461013 date "2008-01-01" @default.
- W2768461013 modified "2023-09-23" @default.
- W2768461013 title "Reply to ''Definition of hepatitis B infection for the best practice in chronic disease and in immunosuppressed patients''" @default.
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