Chronic viral hepatitis B and rheumatic diseases: Modern view on problem

Infection caused by hepatitis B virus (HBV) is one of the most common hemocontact infections. The special life cycle of the hepatitis B virus, the course of infection, often hidden, and the high risk of developing life-threatening conditions, such as fulminant hepatitis and hepatocellular carcinoma, make it necessary to exercise special caution when choosing therapeutic tactics for rheumatological patients, since the vast majority of drugs used in rheumatological practice have immunosuppressive properties. This review updates information on the risks of reactivation of HBV infection in the treatment of currently used antirheumatic drugs, considers difficult to curate variants of chronic hepatitis B with delta agent and extrahepatic manifestations, in particular, thrombocytopenia. The most systematic and consistent approach to ranking the risk of reactivation of HBV infection (low [less than 1 %], moderate [1–10 %] and high [higher than 10 %]), in accordance with the serological status of the patient, as well as the type and duration of immunosuppressive treatment used, is proposed by the American Gastroenterological Association. The authors have attempted to unify the current literature data according to this classification.