The reactivation of HBV in asymptomatic carriers, evidenced as an increase in the alanine aminotransferasa (ALT) or increase in the viral DNA has been described in 20-50% of patients who are subjected to immunosuppressive or neoplasm chemotherapy. Most of the time, decompensations are asymptomatic, but they can show periods of jaundice and severe decompensation. Reactivation has shown to be higher when steroids are part of the treatment. Non-controlled studies have demonstrated that the use of lamivudine reduces reactivation rate and possible complications. It is recommended that any patient who will be subjected to neoplasm chemotherapy or immunosuppressive treatment must be sieved for hepatitis B. There are brief studies that demonstrate that there is higher morbidity when there is virus reactivation in those patients who have had non-hepatic transplants. Most research has been done in patients with renal transplants. There is not normative recommendation about the management of these patients.
Hepatitis B; inactive carriers; immunosuppression