Published online Apr 7, 2014. doi: 10.3748/wjg.v20.i13.3516
Revised: December 13, 2013
Accepted: March 6, 2014
Published online: April 7, 2014
Processing time: 188 Days and 11.5 Hours
In recent years, a number of case reports and clinical studies have highlighted the risk of hepatitis B and C virus reactivation in patients with inflammatory bowel disease who are treated with immunosuppressive drugs. The cases of viral hepatitis reactivation that have been reported are characterized by a wide range of clinical manifestations, from viremia without clinically relevant manifestations to fulminant life-threatening hepatitis. The development and dissemination of biological immunosuppressive drugs have led to a significant increase in the number of reports of interest to physicians in a variety of clinical settings. On this topic, there have been a number of published guidelines and reviews that have collected the available evidence, providing recommendations on prophylactic and therapeutic strategies and methods for monitoring patients at risk. However, it should be noted that, to date, very few clinical studies have been published, and most of the recommendations have been borrowed from other clinical settings. The published studies are mostly retrospective and are based on very heterogeneous populations, using different therapeutic and prophylactic regimens and obtaining conflicting results. Thus, it seems clear that it is desirable to concentrate our efforts on prospective studies, not conducting further reviews of the literature in the continued absence of new evidence.
Core tip: Our review focused on the redundancy of papers on hepatitis B virus and hepatitis C virus reactivation in patients undergoing immunosuppressive therapy. However, we emphasize that, to date, very few clinical studies have been published, and most of them were retrospective with conflicting results. Thus, it is essential to conduct prospective studies before performing additional reviews of the literature.