Hepatitis B virus (HBV) reactivation is a recognized consequence of immune-suppressive, cytotoxic, and biological modifying treatments in patients who are infected with HBV or have previously been exposed to HBV. Although there are newer and emerging forms of targeted biologic therapies available for the management of rheumatologic conditions, malignancies, inflammatory bowel disease, dermatologic conditions, and solid-organ, bone marrow, or haematologic stem cell transplant, there is currently a lack of a systematic approach to the care of patients with or at risk of HBV reactivation. The European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Hepatology Committee, in collaboration with a working group of ESPGHAN members with clinical and research expertise in viral hepatitis, developed an evidence-based position paper on HBV reactivation in children, identifying pertinent issues addressing the diagnosis, prevention, and treatment of this condition. All members of the working group formulated and agreed on relevant clinical issues.
A paper was created, and the members of the working group and the ESPGHAN Hepatology Committee voted on each suggestion using a formal voting mechanism. A recommendation was adopted if at least 75% of the working group members agreed on it. This position paper offers an up-to-date overview of the diagnosis, prevention, and treatment of HBV reactivation in children.
