Management of patients with hepatitis B in special populations

Table 3 Management of chronic hepatitis B in special populations

Special population	Management
Before and after liver transplantation	Before: entecavir or tenofovir (± telbivudine in the presence of renal dysfunction)
	After: HBIG plus entecavir or tenofovir (consider telbivudine in the presence of renal dysfunction)
Before and after kidney transplantation	Before: entecavir or telbivudine or tenofovir (Figure 3)
	After: entecavir or telbivudine or tenofovir in HBsAg(+) recipients [plus HBIG when HBsAg(-) recipients receive graft from HBsAg(+) donor with HBV viremia] (Figure 3)
Pregnancy	lamivudine, telbivudine or tenofovir in the last trimester of pregnancy when HBV DNA > 106 IU/mL
Children	Interferon or nucleos(t)ide analogue (check age of child)
Under immunosuppressive regimen	HBsAg-positive candidates: lamivudine when baseline HBVDNA < 2000 IU/mL and short period (< 12 mo) of immunosuppression; otherwise: ETV or TDF
	HBsAg-negative/anti-HBc positive candidates: (1) if baseline HBV-DNA detectable: as HBsAg-positive candidates; (2) otherwise: lamivudine only in hematological diseases or rituximab containing regimens

HBV: Hepatitis B virus; HBIG: Hepatitis B immunoglobulin; HBsAg: Hepatitis B surface antigen; ETV: Entecavir; TDF: Tenofovir.