Table 3.

Risk of hepatitis B virus reactivation stratified by immunosuppressive regimen

	HBsAg positive	HBsAg negative – anti-HBc positive
High risk >10%	B-cell depleting agents (eg rituximab, ofatumumab) Anthracycline derivatives (eg doxorubicin, epirubicin) Moderate (prednisolone 10–20 mg daily or equivalent) or high-dose (prednisolone >20 mg daily or equivalent) corticosteroids daily for ≥4 weeks Potent TNF-α inhibitors, including adalimumab, certolizumab, infliximab and golimumab Local treatment for HCC, including TACE	B-cell depleting agents (eg rituximab, ofatumumab)
Moderate risk 1-10%	Less potent TNF-α inhibitors (eg etanercept) Cytokine or integrin inhibitors (eg abatacept, ustekinumab, natalizumab, vedolizumab) Tyrosine kinase inhibitors (eg imatinib, nilotinib) Immunophilin inhibitors, including cyclosporine Proteasome inhibitors, such as bortezomib HDIs Low-dose (prednisolone <10 mg daily or equivalent) corticosteroids for duration of ≥4 weeks Systemic chemotherapy	TNF-α inhibitors (eg etanercept, adalimumab, certolizumab, infliximab) Cytokinee or integrin inhibitors (eg abatacept, ustekinumab, natalizumab, vedolizumab) Tyrosine kinase inhibitors (eg imatinib, nilotinib) Moderate (prednisolone 10–20 mg daily or equivalent) or high-dose (prednisolone >20 mg daily or equivalent) corticosteroids daily for ≥4 weeks Anthracycline derivatives (eg doxorubicin, epirubicin) Immunophilin inhibitors, including cyclosporine Proteasome inhibitors, such as bortezomib HDIs Systematic chemotherapy, including HCC
Low risk <1%	Traditional immunosuppressive agents (eg azathioprine, 6-Mercaptopurine, methotrexate) Intra-articular corticosteroids Any dose of oral corticosteroids daily for <1 week	Traditional immunosuppressive agents (eg azathioprine, 6-Mercaptopurine, methotrexate) Intra-articular corticosteroids Low-dose (prednisolone <10 mg or equivalent) corticosteroids for ≥4 weeks Any dose of oral corticosteroids daily for <1 week

Anti-HBc = hepatitis B core antibody; HBsAg = hepatitis B surface antigen; HBVr = hepatitis B virus reactivation; HCC = hepatocellular carcinoma; HDIs = histone deacetylase inhibitors; TACE = transarterial chemoembolization; TNF = tumour necrosis factor