What are the specific drugs that require hepatitis B virus (HBV) panel monitoring?
Essential Drugs Requiring HBV Panel Monitoring: Biologicals, Antiretrovirals, and Immunosuppressives
HBV panel monitoring is required for several classes of drugs due to the risk of hepatitis B virus (HBV) reactivation. These include:
Biological Treatments
Biological drugs, particularly those used in rheumatology and other autoimmune conditions, necessitate HBV screening before initiation. These drugs include:
- Tumor Necrosis Factor (TNF) inhibitors
- Rituximab (RTX)
- Tocilizumab
- Abatacept
- Tofacitinib
These drugs can cause HBV reactivation in patients who are inactive HBV carriers or have resolved HBV infections. Therefore, screening and prophylactic treatment are recommended to prevent reactivation[1].
Antiretroviral Drugs for HIV
Certain antiretroviral (ARV) drugs used to treat HIV are also active against HBV and require monitoring to prevent HBV reactivation. These drugs include:
- Emtricitabine (FTC)
- Lamivudine (3TC)
- Tenofovir disoproxil fumarate (TDF)
- Tenofovir alafenamide (TAF)
Discontinuation of these drugs can lead to serious hepatocellular damage due to HBV reactivation. Therefore, continuous monitoring and appropriate management are crucial for patients with HBV/HIV coinfection[2].
Immunosuppressive Drugs
Medium to high doses of corticosteroids (equivalent to more than 7.5 mg of prednisolone per day) also require HBV panel monitoring due to the increased risk of HBV reactivation when used in combination with other immunosuppressive drugs[1].
In summary, HBV panel monitoring is essential for patients receiving biological treatments, certain antiretroviral drugs for HIV, and medium to high doses of corticosteroids to prevent HBV reactivation and manage potential liver complications effectively.
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