Risk of hepatitis B virus reactivation in patients with resolved infection on therapy with corticosteroids and conventional synthesis immunosuppressants for kidney disease — a single-centre analysis of 258 patients

Background: The risk of hepatitis B virus (HBV) reactivation in patients with a previously resolved HBV (prHBV) infection on therapy with corticosteroids and conventional synthesis immunosuppressants (csISs) for kidney disease has not been well described. Methods We performed a retrospective study on the risk of HBV reactivation (HBVr) in patients with a prHBV infection on therapy with corticosteroids and csISs for kidney disease between January 2012 and December 2021 in the Department of Nephrology at Ruijin Hospital. Results A total of 258 patients with a prHBV infection (all treated with high-dose corticosteroids, of whom 192 were receiving a corticosteroid combined with csISs therapy, including cyclophosphamide (155), cyclosporine A (14), mycophenolate mofetil (14), and tacrolimus (9)) were enrolled. During a mean follow-up time of 21.66 months (range: 9–70 months), HBVr were not observed in these patients. Conclusions Among patients with a prHBV infection on therapy with corticosteroids and csISs for kidney disease, HBVr was not common and severe, suggesting that universal prophylaxis may not be justified or cost-effective in this clinical setting.