The original online version https://doi.org/10.1007/s11629-024-9130-x has wrong title.The correct title for this article should be“Reactivation mechanisms of the ancient Dahekou landslide in Hanzhong City,Shaanxi Pro...The original online version https://doi.org/10.1007/s11629-024-9130-x has wrong title.The correct title for this article should be“Reactivation mechanisms of the ancient Dahekou landslide in Hanzhong City,Shaanxi Province,China”.展开更多
Toxoplasma gondii(T.gondii)is an obligate intracellular parasite with a wide range of hosts,including humans and many warm-blooded animals.The parasite exists in two interconvertible forms,namely tachyzoites and brady...Toxoplasma gondii(T.gondii)is an obligate intracellular parasite with a wide range of hosts,including humans and many warm-blooded animals.The parasite exists in two interconvertible forms,namely tachyzoites and bradyzoites in intermediate hosts that are responsible for acute and chronic infections respectively.Mature bradyzoites accumulate large amounts of amylopectin granules but their roles have not been fully characterized.In this study,the predicted key enzymes involved in amylopectin synthesis(UDP-sugar pyrophospharylase,USP)and degradation(alpha-glucan water dikinase,GWD)of ME49 strain were individually knocked out,and then bradyzoite-related phenotyping experiments in vitro and in vivo were performed to dissect their roles during parasite growth and development.Deletion of the usp or gwd gene in the type II strain ME49 reduced the replication rates of tachyzoites in vitro and parasite virulence in vivo,suggesting that amylopectin metabolism is important for optimal tachyzoite growth.Interestingly,the Δusp mutant grew slightly faster than the parental strain under stress conditions that induced bradyzoite transition,which was likely due to the decreased efficiency of bradyzoite formation of theΔusp mutant.Although theΔgwd mutant could convert to bradyzoite robustly in vitro,it was significantly impaired in establishing chronic infection in vivo.Both the Δusp and Δgwd mutants showed a dramatic reduction in the reactivation of chronic infection in an in vitro model.Together,these results suggest that USP and GWD,which are involved in amylopectin synthesis and degradation have important roles in tachyzoite growth,as well as in the formation and reactivation of bradyzoites in T.gondii.展开更多
With the advancement of fracturing technologies in deeper and more geologically complex formations,fault reactivation and induced seismicity have attracted increasing attention.The increasing frequency and magnitude o...With the advancement of fracturing technologies in deeper and more geologically complex formations,fault reactivation and induced seismicity have attracted increasing attention.The increasing frequency and magnitude of these events underscore the need for a robust understanding of the governing physical mechanisms.Elevated pore pressure,modified fault-loading conditions,and aseismic slip are widely acknowledged as the primary drivers.Recent studies have explored these mechanisms under varying factors,including fluid properties,rock ductility,poroelastic responses,and evolving fault stress states,thereby offering critical insights into model refinement.Probabilistic forecasting approaches,which combine statistical analyses of historical data with real-time monitoring,are being increasingly adopted in seismic risk assessments.In parallel,machine learning techniques are employed to process large seismic datasets and identify key patterns.However,their predictive capabilities remain limited by geological heterogeneity,subsurface complexity,and scarce observational data.Moreover,fluid–rock interactions further complicate the development of universally applicable models,thereby constraining the generalizability of mitigation strategies.This review synthesizes the current understanding of induced seismicity mechanisms,evaluates the prevailing prediction and mitigation methods,and identifies major challenges and future research directions.Advancements in these areas are essential to enhancing seismic risk management and ensuring the safe,sustainable development of deep-subsurface energy resources.展开更多
Elsberg syndrome, or HSV-2 lumbosacral radiculitis, is a rare and underrecognized neurologic condition that mimics cauda equina syndrome (CES). It typically presents with symptoms such as urinary retention, saddle ane...Elsberg syndrome, or HSV-2 lumbosacral radiculitis, is a rare and underrecognized neurologic condition that mimics cauda equina syndrome (CES). It typically presents with symptoms such as urinary retention, saddle anesthesia, and bowel incontinence. This case report describes a 59-year-old immunosuppressed male with idiopathic pulmonary fibrosis who developed Elsberg syndrome due to re-activation of latent HSV-2. The patient experienced progressive lower extremity sensory deficits and genitourinary dysfunction, culminating in a vesiculopustular rash. Diagnosis was confirmed via cerebrospinal fluid analysis and PCR testing of skin lesions. Despite early imaging findings being unremarkable, subsequent MRI revealed enhancement of the conus medullaris and cauda equina. Treatment with intravenous acyclovir, corticosteroids, and supportive therapy led to gradual functional improvement, though sensory deficits and neuropathy persisted. This case highlights the diagnostic challenges and importance of clinical suspicion for HSV-2 reactivation in immunosuppressed patients, as well as considerations for long-term symptom management.展开更多
Ancient landslides with platform geomorphology occasionally reactivate,posing serious geohazards.On September 9,2021,persistent heavy rainfall triggered the reactivation of the Dahekou ancient landslide within a gentl...Ancient landslides with platform geomorphology occasionally reactivate,posing serious geohazards.On September 9,2021,persistent heavy rainfall triggered the reactivation of the Dahekou ancient landslide within a gently sloping geomorphology at the core of Zhangjiantan syncline in China's western Qinling-Daba Mountains.This event caused one death,damaged 80 houses,and blocked the Yushui River.This study reconstructs the sliding process of the Dahekou landslide and deciphers the complex landslide initiation mechanisms through field surveys,unmanned aerial vehicle(UAV)imagery analysis,drilling,electrical resistivity tomography(ERT)and small baseline subset–interferometric synthetic aperture radar(SBAS–InSAR)monitoring.We divide the sliding process of the Dahekou landslide into three stages.Two new landslides(#1 and#2)occurred at 18:30 on September 9,2021.Subsequently,the ancient landslide(#3)slid in the 230°direction at approximately 20:30 on September 9,2021,then changed the direction to 170°–240°at 22:30 on the same day,and moved in the direction of 300°at 10:00 the next day.Finally,the reactivated ancient landslide(#3)formed two partially sliding masses,with volumes of approximately 158×10^(4)m^(3)and 160×10~4 m^(3),along the directions of 170°–240°and 300°,respectively,damaging 80 houses and blocking the Yushui River.Field surveys suggest that new landslides#1 and#2 are rock landslides and soil landslides,respectively,with volumes of approximately 230×10^(4)m^(3)and 7.49×10~4 m^(3).Compared with the InSAR data,the new landslide#1 thrust the ancient landslide#3,with an uplift velocity rate of 22.68 mm/a at the rear edge,from September 2020–September 2021.An analysis of drill hole data reveals that the bedding in the landslide area has complex geological conditions,comprising mudstone prone to slipping with different degrees of weathering.Notably,the core of the Zhangjiatan syncline sits on the sliding bedding of the ancient landslide,contributing to a change in the sliding direction.This comprehensive study reveals that the landslide#1 loading and thrusting,the persistent and heavy rainfall,and the complex geological conditions influenced the reactivated ancient landslide.Considering the intricacies of landslide failure mechanisms,we advocate for giving more attention in the future to the zone of potentially slip-prone strata located at the edge of ancient landslides.展开更多
Fracture(fault)reactivation can lead to dynamic geological hazards including earthquakes,rock collapses,landslides,and rock bursts.True triaxial compression tests were conducted to analyze the fracture reactivation pr...Fracture(fault)reactivation can lead to dynamic geological hazards including earthquakes,rock collapses,landslides,and rock bursts.True triaxial compression tests were conducted to analyze the fracture reactivation process under two different orientations of σ_(2),i.e.σ_(2) parallel to the fracture plane(Scheme 2)and σ_(2) cutting through the fracture plane(Scheme 3),under varying σ_(3) from 10 MPa to 40 MPa.The peak or fracture reactivation strength,deformation,failure mode,and post-peak mechanical behavior of intact(Scheme 1)and pre-fractured(Schemes 2 and 3)specimens were also compared.Results show that for intact specimens,the stress remains nearly constant in the residual sliding stage with no stick-slip,and the newly formed fracture surface only propagates along the σ_(2) direction when σ_(3) ranges from 10 MPa to 30 MPa,while it extends along both σ_(2) and σ_(3) directions when σ_(3) increases to 40 MPa;for the pre-fractured specimens,the fractures are usually reactivated under all the σ_(3) levels in Scheme 2,but fracture reactivation only occurs when σ_(3) is greater than 25 MPa in Scheme 3,below which new faulting traversing the original macro fracture occurs.In all the test schemes,both ε_(2) and ε_(3) experience an accumulative process of elongation,after which an abrupt change occurs at the point of the final failure;the degree of this change is dependent on the orientation of the new faulting or the slip direction of the original fracture,and it is generally more than 10 times larger in the slip direction of the original fracture than in the non-slip direction.Besides,the differential stress(peak stress)required for reactivation and the post-peak stress drop increase with increasing σ_(3).Post-peak stress drop and residual strength in Scheme 3 are generally greater than those in Scheme 2 at the same σ_(3) value.Our study clearly shows that intermediate principal stress orientation not only affects the fracture reactivation strength but also influences the slip deformation and failure modes.These new findings facilitate the mitigation of dynamic geological hazards associated with fracture and fault slip.展开更多
Alcohol consumption poses an escalating public health challenge.However,the impact of alcoholic liver disease(ALD)on post-transplant hepatitis B virus(HBV)reactivation and surgical outcomes remains inadequately charac...Alcohol consumption poses an escalating public health challenge.However,the impact of alcoholic liver disease(ALD)on post-transplant hepatitis B virus(HBV)reactivation and surgical outcomes remains inadequately characterized.Herein,we retrospectively analyzed our cohort(NCT06114251)comprising 453 patients with an HBV background.Propensity score matching(PSM)and sensitivity analyses were employed to assess the influence of ALD on surgical outcomes.Benchmark analysis compared the predictive performance of 21 models for post-transplant HBV reactivation.The Shapley additive explanation(SHAP)algorithm facilitated feature ranking and model interpretation.Patients were stratified into three subgroups based on the alcohol-modified HBV reactivation index(AMBRI).Among the cohort,113 patients(24.9%)had concurrent pre-transplant diagnoses of ALD and HBV infection,while 340(75.1%)had HBV infection alone.The presence of ALD was associated with an elevated risk of HBV reactivation and liver metastasis.PSM and sensitivity analyses revealed significantly lower five-year HBV reactivation-free survival(74.9%vs 85.4%),overall survival(OS,56.2%vs 70.5%),and tumor recurrence-free survival(RFS,47.8%vs 63.3%)in the ALD cohort.In recipients without HBV reactivation,hepatocellular carcinomas(HCCs)arising from both ALD and HBV exhibited inferior RFS(log-rank P=0.026)and OS beyond one year(landmark P=0.032)compared to HBV-related HCC alone.Benchmark analysis identified the surv.cforest model as the optimal predictor,achieving an area under the receiver operating characteristic(AUC)curve of 0.914 in internal validation and 0.884 in external validation,outperforming the published Cox model(AUC=0.78).AMBRI-based stratification delineated three distinct risk subgroups,with the intermediate-and high-risk groups exhibiting significantly worse OS and RFS than the low-risk group.In this study,stratification by AMBRI identified intermediate-and high-risk groups with poorer post-transplant outcomes,underscoring the necessity for intensified surveillance and enhanced HBV treatment regimens,particularly in recipients with pre-transplant ALD.展开更多
Hepatitis B virus(HBV)reactivation(HBVr)represents a severe and potentially life-threatening condition,and preventive measures are available through blood test screening or prophylactic therapy administration.The asse...Hepatitis B virus(HBV)reactivation(HBVr)represents a severe and potentially life-threatening condition,and preventive measures are available through blood test screening or prophylactic therapy administration.The assessment of HBVr traditionally considers factors such as HBV profile,including hepatitis B surface antigen(HBsAg)and antibody to hepatitis B core antigen,along with type of medication(chemotherapy;immunomodulants).Nevertheless,consideration of possible patient’s underlying tumor and the specific malignancy type(solid or hematologic)plays a crucial role and needs to be assessed for decision-making process.展开更多
Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and manageme...Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.展开更多
In this editorial we comment on the article published in the recent issue of the W orld Journal of Gastroenterology.We focus specifically on the problem of occult hepatitis B virus(HBV)infection,that is a result of pr...In this editorial we comment on the article published in the recent issue of the W orld Journal of Gastroenterology.We focus specifically on the problem of occult hepatitis B virus(HBV)infection,that is a result of previous hepatitis B(PHB)and a source for reactivation of HBV.The prevalence of PHB is underestimated due to the lack of population testing programs.However,this condition not only com-plicate anticancer treatment,but may be responsible for the development of other diseases,like cancer or autoimmune disorders.Here we unveil possible mecha-nisms responsible for realization of these processes and suggest practical approa-ches for diagnosis and treatment.展开更多
In this editorial,we offer a summary of the risk associated with hepatitis B reactivation(HBVr)in the setting of both solid and hematologic malignancies treated with Bruton tyrosine kinase(BTK)inhibitors,with insights...In this editorial,we offer a summary of the risk associated with hepatitis B reactivation(HBVr)in the setting of both solid and hematologic malignancies treated with Bruton tyrosine kinase(BTK)inhibitors,with insights derived from current studies.Furthermore,we emphasize the critical need for a framework regarding robust risk evaluation in patients undergoing such treatments.This framework is essential for identifying those at increased risk of HBVr,enabling healthcare providers to implement proactive measures to prevent reactivation and ensure the safe administration of BTK inhibitor therapy.展开更多
This editorial commented on an article in the World Journal of Gastroenterology titled“Risks of Reactivation of Hepatitis B Virus in Oncological Patients Using Tyrosine Kinase-Inhibitors:Case Report and Literature An...This editorial commented on an article in the World Journal of Gastroenterology titled“Risks of Reactivation of Hepatitis B Virus in Oncological Patients Using Tyrosine Kinase-Inhibitors:Case Report and Literature Analysis”by Colapietro et al.In this editorial,we focused on providing a more comprehensive exploration of hepatitis B virus reactivation(HBVr)associated with the usage of tyrosine kinase inhibitors(TKIs).It includes insights into the mechanisms underlying HBV reactivation,the temporal relationship between TKIs and HBV reactivation,and preventive measures.The aim is to understand the need for nucleos(t)ide analogs(NAT)and serial blood tests for early recognition of reactivation and acute liver injury,along with management strategies.TKIs are considered to be an intermediate(1%-10%)of HBVr.Current guidelines stipulate that patients receiving therapy with high or moderate risks of reactivation or recent cancer diagnosis must have at least tested hepatitis B surface antigen,anti-hepatitis B core antigen(HBc),and anti-hepatitis B surface antibody.Anti-HBc screening in highly endemic areas means people with negative tests should be vaccinated against HBV.Nucleoside or nucleotide analogs(NAs)like entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide(TAF)form the basis of HBV reactivation prophylaxis and treatment during immunosuppression.Conversely,lamivudine,telbivudine,and adefovir are generally discouraged due to their reduced antiviral efficacy and higher risk of fostering drug-resistant viral strains.However,these less effective NAs may still be utilized in cases where ETV,TDF,and TAF are not feasible treatment options.展开更多
On September 5,2022,a strong earthquake with a magnitude of MS6.8 struck Luding County in Sichuan Province,China,triggering thousands of landslides along the Dadu River in the northwest-southeast(NW-SE)direction.We in...On September 5,2022,a strong earthquake with a magnitude of MS6.8 struck Luding County in Sichuan Province,China,triggering thousands of landslides along the Dadu River in the northwest-southeast(NW-SE)direction.We investigated the reactivation characteristics of historical landslides within the epicentral area of the Luding earthquake to identify the initiation mechanism of earthquake-induced landslides.Records of the two newly triggered and historical landslides were analyzed using manual and threshold methods;the spatial distribution of landslides was assessed in relation to topographical and geological factors using remote sensing images.This study sheds light on the spatial distribution patterns of landslides,especially those that occur above historical landslide areas.Our results revealed a similarity in the spatial distribution trends between historical landslides and new ones induced by earthquakes.These landslides tend to be concentrated within a range of 0.2 km from the river and 2 km from the fault.Notably,both rivers and faults predominantly influenced the reactivation of historical landslides.Remarkably,the reactivated landslides are characterized by their small to medium size and are predominantly situated in historical landslide zones.The number of reactivated landslides surpassed that of previously documented historical landslides within the study area.We provide insights into the critical factors responsible for historical landslides during the 2022 Luding earthquake,thereby enhancing our understanding of the potential implications for future co-seismic hazard assessments and mitigation strategies.展开更多
The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown possibility.The indication of antiviral prophylaxis w...The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown possibility.The indication of antiviral prophylaxis with nucleo(t)side analogue is given according to the risk of HBV reactivation of the prescribed therapy.Though the advent of new drugs is occurring in all the field of medicine,in the setting of hematologic malignancies the last few years have been characterized by several drug classes and innovative cellular treatment.As novel therapies,there are few data about the rate of HBV reactivation and the decision of starting or not an antiviral prophylaxis could be challenging.Moreover,patients are often treated with a combination of different drugs,so evaluating the actual role of these new therapies in increasing the risk of HBV reactivation is difficult.First results are now available,but further studies are still needed.Patients with chronic HBV infection[hepatitis B surface antigen(HBsAg)positive]are reasonably all treated.Past/resolved HBV patients(HBsAg negative)are the actual area of uncertainty where it could be difficult choosing between prophylaxis and pre-emptive strategy.展开更多
Epstein-Barr virus (EBV) infects over 90% of the global population, establishing latent infections in most individuals. Under specific conditions like inflammation and immune suppression, EBV can be reactivated, leadi...Epstein-Barr virus (EBV) infects over 90% of the global population, establishing latent infections in most individuals. Under specific conditions like inflammation and immune suppression, EBV can be reactivated, leading to the initiation and progression of related diseases. While inflammation is known to induce EBV reactivation, the precise mechanisms underlying this phenomenon remain unclear. Chemokine (C-X-C motif) ligand (CXCL10), a key inflammatory factor, plays a significant role in various infectious diseases. In this study, we investigated how CXCL10 levels regulate the transition between the latent and lytic replication phases of the EBV lifecycle using cell culture, Western blot, fluorescent quantitative PCR, immunofluorescence, and flow cytometric apoptosis assays. Our findings indicate that CXCL10 induces EBV transition from latency to lytic replication through its receptor CXCR3 by regulating the downstream effector, exostosis-like glycosyltransferase 1. Additionally, CXCL10 activates the JAK2/STAT3 pathway. This study confirms the role of CXCL10 in promoting EBV lytic replication, providing crucial insights into the pathogenic mechanisms of inflammation-triggered EBV reactivation.展开更多
Hepatitis B virus(HBV)reactivation poses a significant clinical challenge,espe-cially in patients undergoing immunosuppressive therapies,including mono-clonal antibody treatments.This manuscript briefly explores the c...Hepatitis B virus(HBV)reactivation poses a significant clinical challenge,espe-cially in patients undergoing immunosuppressive therapies,including mono-clonal antibody treatments.This manuscript briefly explores the complex rela-tionship between monoclonal antibody therapy and HBV reactivation,drawing upon current literature and clinical case studies.It delves into the mechanisms underlying this phenomenon,highlighting the importance of risk assessment,monitoring,and prophylactic measures for patients at risk.The manuscript aims to enhance the understanding of HBV reactivation in the context of monoclonal antibody therapy,ultimately facilitating informed clinical decision-making and improved patient care.This paper will also briefly review the definition of HBV activation,assess the risks of reactivation,especially in patients treated with monoclonal antibodies,and consider management for patients with regard to screening,prophylaxis,and treatment.A better understanding of patients at risk can help clinicians provide optimum management to ensure successful patient outcomes and prevent morbidity.展开更多
In recent years,a number of case reports and clinical studies have highlighted the risk of hepatitis B and C virus reactivation in patients with inflammatory bowel disease who are treated with immunosuppressive drugs....In recent years,a number of case reports and clinical studies have highlighted the risk of hepatitis B and C virus reactivation in patients with inflammatory bowel disease who are treated with immunosuppressive drugs.The cases of viral hepatitis reactivation that have been reported are characterized by a wide range of clinical manifestations,from viremia without clinically relevant manifestations to fulminant life-threatening hepatitis.The development and dissemination of biological immunosuppressive drugs have led to a significant increase in the number of reports of interest to physicians in a variety of clinical settings.On this topic,there have been a number of published guidelines and reviews that have collected the available evidence,providing recommendations on prophylactic and therapeutic strategies and methods for monitoring patients at risk.However,it should be noted that,to date,very few clinical studies have been published,and most of the recommendations have been borrowed from otherclinical settings.The published studies are mostly retrospective and are based on very heterogeneous populations,using different therapeutic and prophylactic regimens and obtaining conflicting results.Thus,it seems clear that it is desirable to concentrate our efforts on prospective studies,not conducting further reviews of the literature in the continued absence of new evidence.展开更多
Cancer testis antigens(CTAs)are attractive targets for tumor imm unotherapy because of their tumor specific expression,Since more than half of confirmed CTAs are located on the X-chromosome,we asked whether there is a...Cancer testis antigens(CTAs)are attractive targets for tumor imm unotherapy because of their tumor specific expression,Since more than half of confirmed CTAs are located on the X-chromosome,we asked whether there is a link between CTA expression and X-chromosomes.Recent reports have shown that reactivation of the inactive X-chromosome,known as X-chromosome reactivation(XCR),a unique phenomenon that exists in many high-risk tumors in women,can transform the expression of many X-linked genes from monoallelic to biallelic.展开更多
Reactivation of hepatitis B is defined as the recurrence or an abrupt rise in hepatitis B virus(HBV) replication,often accompanied by an increase in serum transaminase levels,and both events occurring in a patient wit...Reactivation of hepatitis B is defined as the recurrence or an abrupt rise in hepatitis B virus(HBV) replication,often accompanied by an increase in serum transaminase levels,and both events occurring in a patient with a previous inactive hepatitis B infection.This reactivation can occur in situations in which the ratio of HBV replication and immune response is altered.It can happen during the treatment of hemato-oncological malignancies with chemotherapy and in immunosuppression of autoimmune diseases.Clinical manifestations of hepatitis B reactivation are variable and can range from asymptomatic to acute hepatitis,which are sometimes serious and result in acute liver failure with risk of death,and usually occur in the periods between cycles or at the end of chemotherapy.Immunosuppressive drugs such as corticosteroids or azathioprine can induce HBV reactivation in patients carrying hepatitis B virus surface antigen(HBsAg) or anti-HBc,but much less frequently than chemotherapy treatments.The tumor necrosis factorαinhibitors infliximab,etanercept and adalimumab may cause reactivation of hepatitis B,and the overall frequency with infliximab may be similar(50%-66%) to that caused by chemotherapy.Baseline HBV serology is recommended for all patients receiving chemotherapy and immunosuppressive drugs,and HBsAg positive patients should receive anti-HBV prophylaxis to decrease virus reactivation and death rates.展开更多
Due to the inherent relationship between the immune system and the hepatitis B virus(HBV) in exposed and infected individuals, immunomodulation associated with the treatment of solid tumours, haematological malignanci...Due to the inherent relationship between the immune system and the hepatitis B virus(HBV) in exposed and infected individuals, immunomodulation associated with the treatment of solid tumours, haematological malignancies and inflammatory disorders has been linked to HBV reactivation(HBVr). Reactivation of HBV infection in the setting of chemotherapy and immunosuppression may lead to fulminant liver failure and death, but there is a cumulative body of evidence that these are potentially preventable adverse outcomes. As chronic hepatitis B is largely asymptomatic but also endemic worldwide, clinicians caring for patients requiring chemotherapy or immunosuppression need to be vigilant of the potential for HBVr in susceptible individuals. Serological screening and prophylactic and pre-emptive antiviral treatment with a nucleos(t)ide analogue should be considered in appropriate settings. Hepatitis B prevalence is examined in this review article, as are the risks of HBVr in patients receiving chemo- and immunosuppressive therapy. Recommendations regarding screening, monitoring and the role of antiviral prophylaxis are outlined with reference to current international associations' guidelines and the best available evidence to date.展开更多
文摘The original online version https://doi.org/10.1007/s11629-024-9130-x has wrong title.The correct title for this article should be“Reactivation mechanisms of the ancient Dahekou landslide in Hanzhong City,Shaanxi Province,China”.
基金supported by the Fundamental Research Funds for the Central Universities in China(Grant no.2662022DKPY003)the HZAU-AGIS Cooperation Fund(Grant no.SZYJY2022015).
文摘Toxoplasma gondii(T.gondii)is an obligate intracellular parasite with a wide range of hosts,including humans and many warm-blooded animals.The parasite exists in two interconvertible forms,namely tachyzoites and bradyzoites in intermediate hosts that are responsible for acute and chronic infections respectively.Mature bradyzoites accumulate large amounts of amylopectin granules but their roles have not been fully characterized.In this study,the predicted key enzymes involved in amylopectin synthesis(UDP-sugar pyrophospharylase,USP)and degradation(alpha-glucan water dikinase,GWD)of ME49 strain were individually knocked out,and then bradyzoite-related phenotyping experiments in vitro and in vivo were performed to dissect their roles during parasite growth and development.Deletion of the usp or gwd gene in the type II strain ME49 reduced the replication rates of tachyzoites in vitro and parasite virulence in vivo,suggesting that amylopectin metabolism is important for optimal tachyzoite growth.Interestingly,the Δusp mutant grew slightly faster than the parental strain under stress conditions that induced bradyzoite transition,which was likely due to the decreased efficiency of bradyzoite formation of theΔusp mutant.Although theΔgwd mutant could convert to bradyzoite robustly in vitro,it was significantly impaired in establishing chronic infection in vivo.Both the Δusp and Δgwd mutants showed a dramatic reduction in the reactivation of chronic infection in an in vitro model.Together,these results suggest that USP and GWD,which are involved in amylopectin synthesis and degradation have important roles in tachyzoite growth,as well as in the formation and reactivation of bradyzoites in T.gondii.
基金supported in part by the National Key Research and Development Project of China(No.2022YFC3004602)in part by the National Natural Science Foundation of China(Nos.52121003 and 52442406)。
文摘With the advancement of fracturing technologies in deeper and more geologically complex formations,fault reactivation and induced seismicity have attracted increasing attention.The increasing frequency and magnitude of these events underscore the need for a robust understanding of the governing physical mechanisms.Elevated pore pressure,modified fault-loading conditions,and aseismic slip are widely acknowledged as the primary drivers.Recent studies have explored these mechanisms under varying factors,including fluid properties,rock ductility,poroelastic responses,and evolving fault stress states,thereby offering critical insights into model refinement.Probabilistic forecasting approaches,which combine statistical analyses of historical data with real-time monitoring,are being increasingly adopted in seismic risk assessments.In parallel,machine learning techniques are employed to process large seismic datasets and identify key patterns.However,their predictive capabilities remain limited by geological heterogeneity,subsurface complexity,and scarce observational data.Moreover,fluid–rock interactions further complicate the development of universally applicable models,thereby constraining the generalizability of mitigation strategies.This review synthesizes the current understanding of induced seismicity mechanisms,evaluates the prevailing prediction and mitigation methods,and identifies major challenges and future research directions.Advancements in these areas are essential to enhancing seismic risk management and ensuring the safe,sustainable development of deep-subsurface energy resources.
文摘Elsberg syndrome, or HSV-2 lumbosacral radiculitis, is a rare and underrecognized neurologic condition that mimics cauda equina syndrome (CES). It typically presents with symptoms such as urinary retention, saddle anesthesia, and bowel incontinence. This case report describes a 59-year-old immunosuppressed male with idiopathic pulmonary fibrosis who developed Elsberg syndrome due to re-activation of latent HSV-2. The patient experienced progressive lower extremity sensory deficits and genitourinary dysfunction, culminating in a vesiculopustular rash. Diagnosis was confirmed via cerebrospinal fluid analysis and PCR testing of skin lesions. Despite early imaging findings being unremarkable, subsequent MRI revealed enhancement of the conus medullaris and cauda equina. Treatment with intravenous acyclovir, corticosteroids, and supportive therapy led to gradual functional improvement, though sensory deficits and neuropathy persisted. This case highlights the diagnostic challenges and importance of clinical suspicion for HSV-2 reactivation in immunosuppressed patients, as well as considerations for long-term symptom management.
基金funded by the National Natural Science Foundation of China(Grant No.42077257)。
文摘Ancient landslides with platform geomorphology occasionally reactivate,posing serious geohazards.On September 9,2021,persistent heavy rainfall triggered the reactivation of the Dahekou ancient landslide within a gently sloping geomorphology at the core of Zhangjiantan syncline in China's western Qinling-Daba Mountains.This event caused one death,damaged 80 houses,and blocked the Yushui River.This study reconstructs the sliding process of the Dahekou landslide and deciphers the complex landslide initiation mechanisms through field surveys,unmanned aerial vehicle(UAV)imagery analysis,drilling,electrical resistivity tomography(ERT)and small baseline subset–interferometric synthetic aperture radar(SBAS–InSAR)monitoring.We divide the sliding process of the Dahekou landslide into three stages.Two new landslides(#1 and#2)occurred at 18:30 on September 9,2021.Subsequently,the ancient landslide(#3)slid in the 230°direction at approximately 20:30 on September 9,2021,then changed the direction to 170°–240°at 22:30 on the same day,and moved in the direction of 300°at 10:00 the next day.Finally,the reactivated ancient landslide(#3)formed two partially sliding masses,with volumes of approximately 158×10^(4)m^(3)and 160×10~4 m^(3),along the directions of 170°–240°and 300°,respectively,damaging 80 houses and blocking the Yushui River.Field surveys suggest that new landslides#1 and#2 are rock landslides and soil landslides,respectively,with volumes of approximately 230×10^(4)m^(3)and 7.49×10~4 m^(3).Compared with the InSAR data,the new landslide#1 thrust the ancient landslide#3,with an uplift velocity rate of 22.68 mm/a at the rear edge,from September 2020–September 2021.An analysis of drill hole data reveals that the bedding in the landslide area has complex geological conditions,comprising mudstone prone to slipping with different degrees of weathering.Notably,the core of the Zhangjiatan syncline sits on the sliding bedding of the ancient landslide,contributing to a change in the sliding direction.This comprehensive study reveals that the landslide#1 loading and thrusting,the persistent and heavy rainfall,and the complex geological conditions influenced the reactivated ancient landslide.Considering the intricacies of landslide failure mechanisms,we advocate for giving more attention in the future to the zone of potentially slip-prone strata located at the edge of ancient landslides.
基金funding support from the National Nature Science Foundation of China(Grant No.42272334)the National Key Research and Development Program of China(Grant No.2022YFE0137200)the Taishan Scholars Program(Grant No.2019RKB01083).
文摘Fracture(fault)reactivation can lead to dynamic geological hazards including earthquakes,rock collapses,landslides,and rock bursts.True triaxial compression tests were conducted to analyze the fracture reactivation process under two different orientations of σ_(2),i.e.σ_(2) parallel to the fracture plane(Scheme 2)and σ_(2) cutting through the fracture plane(Scheme 3),under varying σ_(3) from 10 MPa to 40 MPa.The peak or fracture reactivation strength,deformation,failure mode,and post-peak mechanical behavior of intact(Scheme 1)and pre-fractured(Schemes 2 and 3)specimens were also compared.Results show that for intact specimens,the stress remains nearly constant in the residual sliding stage with no stick-slip,and the newly formed fracture surface only propagates along the σ_(2) direction when σ_(3) ranges from 10 MPa to 30 MPa,while it extends along both σ_(2) and σ_(3) directions when σ_(3) increases to 40 MPa;for the pre-fractured specimens,the fractures are usually reactivated under all the σ_(3) levels in Scheme 2,but fracture reactivation only occurs when σ_(3) is greater than 25 MPa in Scheme 3,below which new faulting traversing the original macro fracture occurs.In all the test schemes,both ε_(2) and ε_(3) experience an accumulative process of elongation,after which an abrupt change occurs at the point of the final failure;the degree of this change is dependent on the orientation of the new faulting or the slip direction of the original fracture,and it is generally more than 10 times larger in the slip direction of the original fracture than in the non-slip direction.Besides,the differential stress(peak stress)required for reactivation and the post-peak stress drop increase with increasing σ_(3).Post-peak stress drop and residual strength in Scheme 3 are generally greater than those in Scheme 2 at the same σ_(3) value.Our study clearly shows that intermediate principal stress orientation not only affects the fracture reactivation strength but also influences the slip deformation and failure modes.These new findings facilitate the mitigation of dynamic geological hazards associated with fracture and fault slip.
基金supported by the National Natural Science Foun-dation of China(92159202)the National Science and Technology Major Project of China(2017ZX10203205)+4 种基金the Fundamental Research Funds for the Central Universities(2022ZFJH003)the Major Research Plan of Key Research and Development Project of Zhejiang Province(2024C03149 and 2023C03046)the National Key Research and Development Program of China(2021YFF1200404 and 2021YFA1201200)the Zhejiang Provincial Natural Science Foundation of China(LQ24C050005 and LQ22H160052)the Medical and Health Technology Program Project of Zhejiang Province(2021434810).
文摘Alcohol consumption poses an escalating public health challenge.However,the impact of alcoholic liver disease(ALD)on post-transplant hepatitis B virus(HBV)reactivation and surgical outcomes remains inadequately characterized.Herein,we retrospectively analyzed our cohort(NCT06114251)comprising 453 patients with an HBV background.Propensity score matching(PSM)and sensitivity analyses were employed to assess the influence of ALD on surgical outcomes.Benchmark analysis compared the predictive performance of 21 models for post-transplant HBV reactivation.The Shapley additive explanation(SHAP)algorithm facilitated feature ranking and model interpretation.Patients were stratified into three subgroups based on the alcohol-modified HBV reactivation index(AMBRI).Among the cohort,113 patients(24.9%)had concurrent pre-transplant diagnoses of ALD and HBV infection,while 340(75.1%)had HBV infection alone.The presence of ALD was associated with an elevated risk of HBV reactivation and liver metastasis.PSM and sensitivity analyses revealed significantly lower five-year HBV reactivation-free survival(74.9%vs 85.4%),overall survival(OS,56.2%vs 70.5%),and tumor recurrence-free survival(RFS,47.8%vs 63.3%)in the ALD cohort.In recipients without HBV reactivation,hepatocellular carcinomas(HCCs)arising from both ALD and HBV exhibited inferior RFS(log-rank P=0.026)and OS beyond one year(landmark P=0.032)compared to HBV-related HCC alone.Benchmark analysis identified the surv.cforest model as the optimal predictor,achieving an area under the receiver operating characteristic(AUC)curve of 0.914 in internal validation and 0.884 in external validation,outperforming the published Cox model(AUC=0.78).AMBRI-based stratification delineated three distinct risk subgroups,with the intermediate-and high-risk groups exhibiting significantly worse OS and RFS than the low-risk group.In this study,stratification by AMBRI identified intermediate-and high-risk groups with poorer post-transplant outcomes,underscoring the necessity for intensified surveillance and enhanced HBV treatment regimens,particularly in recipients with pre-transplant ALD.
文摘Hepatitis B virus(HBV)reactivation(HBVr)represents a severe and potentially life-threatening condition,and preventive measures are available through blood test screening or prophylactic therapy administration.The assessment of HBVr traditionally considers factors such as HBV profile,including hepatitis B surface antigen(HBsAg)and antibody to hepatitis B core antigen,along with type of medication(chemotherapy;immunomodulants).Nevertheless,consideration of possible patient’s underlying tumor and the specific malignancy type(solid or hematologic)plays a crucial role and needs to be assessed for decision-making process.
文摘Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.
基金Supported by Ministry of Science and Higher education of Russia,No.FGMF-2022-0005Moscow Healthcare Department,No.123040700014-4.
文摘In this editorial we comment on the article published in the recent issue of the W orld Journal of Gastroenterology.We focus specifically on the problem of occult hepatitis B virus(HBV)infection,that is a result of previous hepatitis B(PHB)and a source for reactivation of HBV.The prevalence of PHB is underestimated due to the lack of population testing programs.However,this condition not only com-plicate anticancer treatment,but may be responsible for the development of other diseases,like cancer or autoimmune disorders.Here we unveil possible mecha-nisms responsible for realization of these processes and suggest practical approa-ches for diagnosis and treatment.
文摘In this editorial,we offer a summary of the risk associated with hepatitis B reactivation(HBVr)in the setting of both solid and hematologic malignancies treated with Bruton tyrosine kinase(BTK)inhibitors,with insights derived from current studies.Furthermore,we emphasize the critical need for a framework regarding robust risk evaluation in patients undergoing such treatments.This framework is essential for identifying those at increased risk of HBVr,enabling healthcare providers to implement proactive measures to prevent reactivation and ensure the safe administration of BTK inhibitor therapy.
文摘This editorial commented on an article in the World Journal of Gastroenterology titled“Risks of Reactivation of Hepatitis B Virus in Oncological Patients Using Tyrosine Kinase-Inhibitors:Case Report and Literature Analysis”by Colapietro et al.In this editorial,we focused on providing a more comprehensive exploration of hepatitis B virus reactivation(HBVr)associated with the usage of tyrosine kinase inhibitors(TKIs).It includes insights into the mechanisms underlying HBV reactivation,the temporal relationship between TKIs and HBV reactivation,and preventive measures.The aim is to understand the need for nucleos(t)ide analogs(NAT)and serial blood tests for early recognition of reactivation and acute liver injury,along with management strategies.TKIs are considered to be an intermediate(1%-10%)of HBVr.Current guidelines stipulate that patients receiving therapy with high or moderate risks of reactivation or recent cancer diagnosis must have at least tested hepatitis B surface antigen,anti-hepatitis B core antigen(HBc),and anti-hepatitis B surface antibody.Anti-HBc screening in highly endemic areas means people with negative tests should be vaccinated against HBV.Nucleoside or nucleotide analogs(NAs)like entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide(TAF)form the basis of HBV reactivation prophylaxis and treatment during immunosuppression.Conversely,lamivudine,telbivudine,and adefovir are generally discouraged due to their reduced antiviral efficacy and higher risk of fostering drug-resistant viral strains.However,these less effective NAs may still be utilized in cases where ETV,TDF,and TAF are not feasible treatment options.
基金financially supported by the National Key R&D Program of China (No. 2022YFF0800604)the National Natural Science Foundation of China (No. 42207224)the State Key Laboratory of Geohazard Prevention and Geoenvironment Protection Independent Research Project (SKLGP2022Z021)
文摘On September 5,2022,a strong earthquake with a magnitude of MS6.8 struck Luding County in Sichuan Province,China,triggering thousands of landslides along the Dadu River in the northwest-southeast(NW-SE)direction.We investigated the reactivation characteristics of historical landslides within the epicentral area of the Luding earthquake to identify the initiation mechanism of earthquake-induced landslides.Records of the two newly triggered and historical landslides were analyzed using manual and threshold methods;the spatial distribution of landslides was assessed in relation to topographical and geological factors using remote sensing images.This study sheds light on the spatial distribution patterns of landslides,especially those that occur above historical landslide areas.Our results revealed a similarity in the spatial distribution trends between historical landslides and new ones induced by earthquakes.These landslides tend to be concentrated within a range of 0.2 km from the river and 2 km from the fault.Notably,both rivers and faults predominantly influenced the reactivation of historical landslides.Remarkably,the reactivated landslides are characterized by their small to medium size and are predominantly situated in historical landslide zones.The number of reactivated landslides surpassed that of previously documented historical landslides within the study area.We provide insights into the critical factors responsible for historical landslides during the 2022 Luding earthquake,thereby enhancing our understanding of the potential implications for future co-seismic hazard assessments and mitigation strategies.
文摘The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown possibility.The indication of antiviral prophylaxis with nucleo(t)side analogue is given according to the risk of HBV reactivation of the prescribed therapy.Though the advent of new drugs is occurring in all the field of medicine,in the setting of hematologic malignancies the last few years have been characterized by several drug classes and innovative cellular treatment.As novel therapies,there are few data about the rate of HBV reactivation and the decision of starting or not an antiviral prophylaxis could be challenging.Moreover,patients are often treated with a combination of different drugs,so evaluating the actual role of these new therapies in increasing the risk of HBV reactivation is difficult.First results are now available,but further studies are still needed.Patients with chronic HBV infection[hepatitis B surface antigen(HBsAg)positive]are reasonably all treated.Past/resolved HBV patients(HBsAg negative)are the actual area of uncertainty where it could be difficult choosing between prophylaxis and pre-emptive strategy.
文摘Epstein-Barr virus (EBV) infects over 90% of the global population, establishing latent infections in most individuals. Under specific conditions like inflammation and immune suppression, EBV can be reactivated, leading to the initiation and progression of related diseases. While inflammation is known to induce EBV reactivation, the precise mechanisms underlying this phenomenon remain unclear. Chemokine (C-X-C motif) ligand (CXCL10), a key inflammatory factor, plays a significant role in various infectious diseases. In this study, we investigated how CXCL10 levels regulate the transition between the latent and lytic replication phases of the EBV lifecycle using cell culture, Western blot, fluorescent quantitative PCR, immunofluorescence, and flow cytometric apoptosis assays. Our findings indicate that CXCL10 induces EBV transition from latency to lytic replication through its receptor CXCR3 by regulating the downstream effector, exostosis-like glycosyltransferase 1. Additionally, CXCL10 activates the JAK2/STAT3 pathway. This study confirms the role of CXCL10 in promoting EBV lytic replication, providing crucial insights into the pathogenic mechanisms of inflammation-triggered EBV reactivation.
文摘Hepatitis B virus(HBV)reactivation poses a significant clinical challenge,espe-cially in patients undergoing immunosuppressive therapies,including mono-clonal antibody treatments.This manuscript briefly explores the complex rela-tionship between monoclonal antibody therapy and HBV reactivation,drawing upon current literature and clinical case studies.It delves into the mechanisms underlying this phenomenon,highlighting the importance of risk assessment,monitoring,and prophylactic measures for patients at risk.The manuscript aims to enhance the understanding of HBV reactivation in the context of monoclonal antibody therapy,ultimately facilitating informed clinical decision-making and improved patient care.This paper will also briefly review the definition of HBV activation,assess the risks of reactivation,especially in patients treated with monoclonal antibodies,and consider management for patients with regard to screening,prophylaxis,and treatment.A better understanding of patients at risk can help clinicians provide optimum management to ensure successful patient outcomes and prevent morbidity.
文摘In recent years,a number of case reports and clinical studies have highlighted the risk of hepatitis B and C virus reactivation in patients with inflammatory bowel disease who are treated with immunosuppressive drugs.The cases of viral hepatitis reactivation that have been reported are characterized by a wide range of clinical manifestations,from viremia without clinically relevant manifestations to fulminant life-threatening hepatitis.The development and dissemination of biological immunosuppressive drugs have led to a significant increase in the number of reports of interest to physicians in a variety of clinical settings.On this topic,there have been a number of published guidelines and reviews that have collected the available evidence,providing recommendations on prophylactic and therapeutic strategies and methods for monitoring patients at risk.However,it should be noted that,to date,very few clinical studies have been published,and most of the recommendations have been borrowed from otherclinical settings.The published studies are mostly retrospective and are based on very heterogeneous populations,using different therapeutic and prophylactic regimens and obtaining conflicting results.Thus,it seems clear that it is desirable to concentrate our efforts on prospective studies,not conducting further reviews of the literature in the continued absence of new evidence.
文摘Cancer testis antigens(CTAs)are attractive targets for tumor imm unotherapy because of their tumor specific expression,Since more than half of confirmed CTAs are located on the X-chromosome,we asked whether there is a link between CTA expression and X-chromosomes.Recent reports have shown that reactivation of the inactive X-chromosome,known as X-chromosome reactivation(XCR),a unique phenomenon that exists in many high-risk tumors in women,can transform the expression of many X-linked genes from monoallelic to biallelic.
文摘Reactivation of hepatitis B is defined as the recurrence or an abrupt rise in hepatitis B virus(HBV) replication,often accompanied by an increase in serum transaminase levels,and both events occurring in a patient with a previous inactive hepatitis B infection.This reactivation can occur in situations in which the ratio of HBV replication and immune response is altered.It can happen during the treatment of hemato-oncological malignancies with chemotherapy and in immunosuppression of autoimmune diseases.Clinical manifestations of hepatitis B reactivation are variable and can range from asymptomatic to acute hepatitis,which are sometimes serious and result in acute liver failure with risk of death,and usually occur in the periods between cycles or at the end of chemotherapy.Immunosuppressive drugs such as corticosteroids or azathioprine can induce HBV reactivation in patients carrying hepatitis B virus surface antigen(HBsAg) or anti-HBc,but much less frequently than chemotherapy treatments.The tumor necrosis factorαinhibitors infliximab,etanercept and adalimumab may cause reactivation of hepatitis B,and the overall frequency with infliximab may be similar(50%-66%) to that caused by chemotherapy.Baseline HBV serology is recommended for all patients receiving chemotherapy and immunosuppressive drugs,and HBsAg positive patients should receive anti-HBV prophylaxis to decrease virus reactivation and death rates.
文摘Due to the inherent relationship between the immune system and the hepatitis B virus(HBV) in exposed and infected individuals, immunomodulation associated with the treatment of solid tumours, haematological malignancies and inflammatory disorders has been linked to HBV reactivation(HBVr). Reactivation of HBV infection in the setting of chemotherapy and immunosuppression may lead to fulminant liver failure and death, but there is a cumulative body of evidence that these are potentially preventable adverse outcomes. As chronic hepatitis B is largely asymptomatic but also endemic worldwide, clinicians caring for patients requiring chemotherapy or immunosuppression need to be vigilant of the potential for HBVr in susceptible individuals. Serological screening and prophylactic and pre-emptive antiviral treatment with a nucleos(t)ide analogue should be considered in appropriate settings. Hepatitis B prevalence is examined in this review article, as are the risks of HBVr in patients receiving chemo- and immunosuppressive therapy. Recommendations regarding screening, monitoring and the role of antiviral prophylaxis are outlined with reference to current international associations' guidelines and the best available evidence to date.
