. Author manuscript; available in PMC: 2014 Oct 1.

Published in final edited form as: Nat Rev Gastroenterol Hepatol. 2013 Nov 19;11(4):209–219. doi: 10.1038/nrgastro.2013.216

Table 2.

Risk stratification for HBV reactivation

	HBsAg+	HBsAg− and anti-HBc+^*	Antiviral therapy
High risk	Chemotherapy Anti-CD20 and/or anti-CD52 agents IST for transplantation (stem cell, solid organ) Steroids in combination with other IST	Chemotherapy for haematological malignancies Anti-CD20 and/or anti-CD52 agents	Prophylaxis
Moderate risk	Anti-TNF agents; Maintenance low dose steroids alone^‡; Other IST without steroids^‡	Chemotherapy for solid tumours^‡; IST for transplantation (stem cell, solid organ)^‡; Steroids in combination with other IST^‡	Prophylaxis or pre-emptive
Low risk	Steroids alone for a few days^‡	Anti-TNF agent^‡; maintenance on low-dose steroids alone^‡; other immunosuppressive therapy without steroids^‡	No prophylaxis

Risk of HBV reactivation in HBsAg-/anti-HBc+ patients with detectable serum HBV DNA at baseline should be considered same as HBsAg+ patients.

^‡

HBV reactivation has been reported in these settings but there is limited data to classify risk.

Abbreviations: +, positive; −, negative; anti-HBc, anti-hepatitis B core antibody IgG; HBsAg, hepatitis B surface antigen; IST, immunosuppressive therapy.