Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.539
Peer-review started: August 30, 2014
First decision: November 14, 2014
Revised: December 28, 2014
Accepted: January 9, 2015
Article in press: January 9, 2015
Published online: March 27, 2015
Core tip: Few reviews have been published including data of the three more common inflammatory diseases that require immunosuppressive therapy: inflammatory bowel disease, rheumatic and dermatologic diseases. This paper is focused on the risk of reactivation of hepatitis B virus under immunosuppressants, and particularly corticosteroids. Although most of the guidelines do not specify the necessity of prophylaxis in case of monotherapy with corticosteroids, the specialists responsible of these patients are usually concerned about this issue. Moreover, the risk with low systemic bioavailability new corticosteroids has not been evaluated in previous reviews. This work summarizes the evidence of VHB reactivation in patients with inflammatory diseases: when and how to apply prophylaxis, with a special focus on “new” and “old” steroids.