Hepatitis B reactivation in the setting of chemotherapy and immunosuppression - prevention is better than cure

Table 1 Populations at high risk for hepatitis B virus infection that should be screened[4]

Individuals born in areas of high (≥ 8%) or intermediate prevalence (2%-7%) for HBV (HBsAg positive) including immigrants and adopted children

Asia, Africa, South Pacific Islands: All countries

Middle East (except Cyprus and Israel)

Eastern Europe: All countries except Hungary

European Mediterranean: Malta and Spain

The Arctic (indigenous populations of Alaska, Canada, and Greenland)

South America: Ecuador, Guyana, Suriname, Venezuela, and Amazon regions of Bolivia, Brazil, Colombia, and Peru

Caribbean: Antigua and Barbuda, Dominica, Granada, Haiti, Jamaica, St. Kitts and Nevis, St. Lucia, and Turks and Caicos

Central America: Guatemala and Honduras

Other groups recommended for screening

United States born persons not vaccinated as infants whose parents were born in regions with high HBV endemicity (8%)

Household and sexual contacts of HBsAg-positive persons

Persons who have ever injected drugs

Persons with multiple sexual partners or history of sexually transmitted disease

Men who have sex with men

Inmates of correctional facilities

Individuals with chronically elevated ALT or AST

Individuals infected with HCV or HIV

Patients undergoing renal dialysis

All pregnant women

Persons needing immunosuppressive therapy

HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; HCV: Hepatitis C virus; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; HIV: Human immunodeficiency virus.