{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:26:53Z","timestamp":1789586813315,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>This study evaluated the characteristics of patients receiving prophylactic antiviral therapy against hepatitis B virus (HBV) infection due to immunosuppressive treatment and assessed the occurrence of HBV reactivation. Between January 2015 and January 2025, 199 adult patients followed in the Infectious Diseases and Clinical Microbiology outpatient clinic who had received prophylactic oral antiviral therapy were retrospectively analyzed. Demographic characteristics, underlying diseases, immunosuppressive treatment history, HBV serological results, biochemical and virological findings, and prophylactic antiviral regimens were recorded. Patients were stratified into low-, moderate-, and high-risk groups according to the American Gastroenterological Association (AGA) 2025 classification. The mean age was 60.4 years; 50.3% of patients were male. Serologically, 26.6% were HBsAg- and anti-HBc-positive, 33.2% showed isolated anti-HBc positivity, and 40.2% had dual anti-HBc\/anti-HBs positivity. The risk of HBV reactivation was low in 41.2%, moderate in 22.1%, and high in 36.7% of patients. Prophylaxis consisted of entecavir in 76.4%, tenofovir alafenamide in 13.1%, and tenofovir disoproxil fumarate in 10.5%. HBV reactivation occurred in only one patient, who had discontinued treatment. These findings emphasize the importance of HBV screening and timely prophylactic antiviral therapy in patients undergoing immunosuppression to effectively prevent HBV reactivation.<\/jats:p>","DOI":"10.3390\/v17111436","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T09:16:24Z","timestamp":1761729384000},"page":"1436","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Real-World Effectiveness of Antiviral Prophylaxis for Preventing Hepatitis B Virus (HBV) Reactivation in Patients Undergoing Immunosuppressive Therapy"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2987-1534","authenticated-orcid":false,"given":"\u0130nci","family":"Y\u0131lmaz Nakir","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, \u0130stanbul 34096, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2718-4044","authenticated-orcid":false,"given":"Bilge","family":"\u00c7a\u011flar","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, \u0130stanbul 34096, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7023-6639","authenticated-orcid":false,"given":"Esra","family":"Zerdali","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, \u0130stanbul 34096, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8985-0559","authenticated-orcid":false,"given":"Rumeysa G\u00fclistan","family":"Karaduman","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, \u0130stanbul 34096, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9943-6004","authenticated-orcid":false,"given":"Filiz","family":"Pehlivano\u011flu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, \u0130stanbul 34096, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1038\/s41575-023-00760-9","article-title":"Global burden of hepatitis B virus: Current status, missed opportunities and a call for action","volume":"20","author":"Hsu","year":"2023","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_2","unstructured":"World Health Organization (2024). Global Hepatitis Report 2024: Action for Access in Low- and Middle-Income Countries, World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240091672."},{"key":"ref_3","unstructured":"Turkish Association for the Study of the Liver (TASL), and Viral Hepatitis Society of Turkey (VHSD) (2025, August 27). Turkey Hepatitis B Diagnosis and Treatment Guideline. Available online: https:\/\/www.tkad.org.tr\/wp-content\/uploads\/2023\/11\/TURKIYE-HEPATIT-B-TANI-VE-TEDAVI-KLAVUZU-2023.pdf."},{"key":"ref_4","first-page":"446","article-title":"Tenofovir alafenamide prophylaxis for the prevention of HBV reactivation in immunosuppressed subjects: A multicenter study","volume":"47","author":"Demirdal","year":"2022","journal-title":"Cukurova Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Anvari, S., and Tsoi, K. (2024). Hepatitis B Virus Reactivation with Immunosuppression: A Hidden Threat?. J. Clin. Med., 13.","DOI":"10.3390\/jcm13020393"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e64","DOI":"10.1038\/emi.2014.64","article-title":"Persistence of hepatitis B virus covalently closed circular DNA in hepatocytes: Molecular mechanisms and clinical significance","volume":"3","author":"Yang","year":"2014","journal-title":"Emerg. Microbes. Infect."},{"key":"ref_7","first-page":"m2200","article-title":"Hepatitis B virus persistence and reactivation","volume":"370","author":"Shi","year":"2020","journal-title":"BMJ Clin. Res. Ed."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"561","DOI":"10.5152\/tjg.2018.18032","article-title":"Reactivation rates in patients using biological agents, with resolved HBV infection or isolated anti-HBc IgG positivity","volume":"29","author":"Solay","year":"2018","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1053\/j.gastro.2024.11.008","article-title":"AGA clinical practice guideline on the prevention and treatment of hepatitis B virus reactivation in at-risk individuals","volume":"168","author":"Ali","year":"2025","journal-title":"Gastroenterology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"275","DOI":"10.5501\/wjv.v11.i5.275","article-title":"Hepatitis B virus infection reactivation in patients under immunosuppressive therapies: Pathogenesis, screening, prevention and treatment","volume":"11","author":"Spera","year":"2022","journal-title":"World J. Virol."},{"key":"ref_11","unstructured":"European Association for the Study of the Liver EASL (2025). Clinical Practice Guidelines on the management of hepatitis B virus infection. J. Hepatol., 83, 502\u2013583."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"825","DOI":"10.4254\/wjh.v7.i6.825","article-title":"Hepatitis B virus reactivation during immunosuppressive therapy: Appropriate risk stratification","volume":"7","author":"Seto","year":"2015","journal-title":"World J. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/s11606-022-07806-9","article-title":"Prevention of hepatitis B reactivation in patients receiving immunosuppressive therapy: A case series and appraisal of society guidelines","volume":"38","author":"Etienne","year":"2023","journal-title":"J. Gen. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s12072-017-9817-y","article-title":"Risk of hepatitis B reactivation in HBsAg-negative\/HBcAb-positive patients with undetectable serum HBV DNA after treatment with rituximab for lymphoma: A meta-analysis","volume":"11","author":"Tang","year":"2017","journal-title":"Hepatol. Int."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Buti, M., Manzano, M.L., Morillas, R.M., Garc\u00eda-Retortillo, M., Mart\u00edn, L., Prieto, M., Guti\u00e9rrez, M.L., Su\u00e1rez, E., G\u00f3mez Rubio, M., and L\u00f3pez, J. (2017). Randomized prospective study evaluating tenofovir disoproxil fumarate prophylaxis against hepatitis B virus reactivation in anti-HBc-positive patients with rituximab-based regimens to treat hematologic malignancies: The Preblin study. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0184550"},{"key":"ref_16","first-page":"112","article-title":"Evaluation of the risk of hepatitis B reactivation in patients receiving immunosuppressive therapy","volume":"1","author":"Ceylan","year":"2022","journal-title":"Izmir Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1111\/ajco.13050","article-title":"Prevalence and risk factors of hepatitis B virus reactivation in patients with solid tumors with resolved HBV infection","volume":"15","author":"Kotake","year":"2019","journal-title":"Asia-Pac. J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1002\/hep.29800","article-title":"Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance","volume":"67","author":"Terrault","year":"2018","journal-title":"Hepatology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1111\/jvh.12933","article-title":"Hepatitis B virus reactivation in patients with rheumatoid arthritis: Analysis of the national database of Japan","volume":"25","author":"Fujita","year":"2018","journal-title":"J. Viral Hepat."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.cmi.2022.02.042","article-title":"Hepatitis B virus and hepatitis C virus reactivation in cancer patients receiving novel anticancer therapies","volume":"28","author":"Mustafayev","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1159\/000519440","article-title":"Real-world single-center comparison of the safety and efficacy of entecavir, tenofovir disoproxil fumarate, and tenofovir alafenamide in patients with chronic hepatitis B","volume":"65","author":"Jeong","year":"2022","journal-title":"Intervirology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"809","DOI":"10.16899\/jcm.1343166","article-title":"Evaluation of HBV Reactivation and Antiviral Prophylaxis in Patients Receiving Immunosuppressive Therapy","volume":"13","author":"Ahmet","year":"2023","journal-title":"J. Contemp. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Chen, M.B., Wang, H., Zheng, Q.H., Zheng, X.W., Fan, J.N., Ding, Y.L., and Niu, J.L. (2019). Comparative efficacy of tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B: A systematic review and meta-analysis. 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