Table 1.
National hepatitis B virus (HBV) screening recommendations
| Organization | Definition of reactivation |
Population to be screened before immunosuppression |
Screening tests |
Duration of prophylaxis |
Patients who should get prophylaxis |
Antiviral therapy |
|---|---|---|---|---|---|---|
| CDC | Fulminant hepatitis | All patients | HBsAg, anti-HBc, anti-HBs | No specific statement | HBsAg positive | No specific antiviral recommended |
| AASLD | Elevated ALT and HBV DNA | Patients with risk factors for HBV infection | HBsAg, anti-HBc, anti-HBs | From before chemotherapy until 6 months after completion | HBsAg positive | Lamivudine; for patients requiring more than 12 months of therapy, adefovir or entecavir is recommended |
| IOM | Icteric flares or hepatic decompensation | Patients with risk factors for HBV infection | HBsAg | No specific statement | HBsAg positive | No specific statement |
| ASCO | Fulminant hepatitis or liver failure | Patients with risk factors for HBV infection, anticipated rituximab therapy, or anticipated stem cell transplantation | HBsAg, anti-HBc (in certain cases) | No specific statement | HBsAg positive | No specific antiviral recommended |
| NCCN | Fulminant hepatitis or liver failure | Patients with risk factors for HBV infection, anticipated intensive immunosuppression, or anticipated stem cell transplantation | HBsAg, anti-HBc, anti-HBs | No specific statement | “Active HBV infection” | Lamivudine, tenofovir, adefovir, or entecavir |
CDC Centers for Disease Control and Prevention, AASLD American Association for the Study of Liver Diseases, IOM Institute of Medicine, ASCO American Society of Clinical Oncology, NCCN National Comprehensive Cancer Network, ALT alanine aminotransferase, HBsAg HBV surface antigen, anti-HBc antibody to HBV core antigen, anti-HBs antibody to HBV surface antigen