Viral Hepatitis and Inflammatory Bowel Disease

被引:66
作者
Hou, Jason K. [2 ]
Velayos, Fernando [1 ]
Terrault, Norah [1 ]
Mahadevan, Uma [1 ]
机构
[1] Univ Calif San Francisco, San Francisco, CA 94115 USA
[2] Baylor Coll Med, Houston, TX 77030 USA
关键词
inflammatory bowel disease; Crohn's disease; ulcerative colitis; hepatitis A; hepatitis B; hepatitis C; viral hepatitis; vaccination; ACTIVE ULCERATIVE-COLITIS; PLACEBO-CONTROLLED TRIAL; PEG-INTERFERON ALPHA-2B; NECROSIS-FACTOR-ALPHA; B-VIRUS REACTIVATION; CROHNS-DISEASE; CYTOTOXIC CHEMOTHERAPY; INFLIXIMAB THERAPY; RISK-FACTORS; PREEMPTIVE LAMIVUDINE;
D O I
10.1002/ibd.21284
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Viral hepatitis is common worldwide and in the United States. Inflammatory bowel disease (IBD) patients with chronic hepatitis B virus (HBV) with active disease (elevated alanine aminotransferase level and viral replication) should receive HBV treatment. HBV reactivation is associated with significant morbidity and mortality in patients receiving immunosuppression. IBD patients may require long-term immunosuppression, and therefore should be considered candidates for vaccination against new HBV infection as well as prophylaxis against HBV reactivation prior to immunosuppressive therapy. Tumor necrosis factor alpha antagonists and immunomodulators appear compatible with use in IBD patients with HCV, although prednisone may increase viral replication. HCV treatment with peg-interferon and ribavirin may exacerbate gastrointestinal symptoms, and therefore the decision to treat HCV needs to be individualized. Management of IBD patients with viral hepatitis is addressed in this review.
引用
收藏
页码:925 / 932
页数:8
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