| [ Summary ] |
Covalently closed circular DNA from HBV genome inevitably remains in of hepatocyte nuclei in patients with previously resolved HBV (prHBV) infection in whom serum ant‒HBc and/or anti‒HBs were positivity despite having negative serum HBs‒antigen. Thus, liver injuries due to HBV proliferation may develop in patients with prHBV infections as well as in HBV carriers with positive serum HBs‒antigen during and after immunosuppressive therapies and/or antineoplastic chemotherapies. Fulminant de novo hepatitis B frequently occurs in patients with prHBV infection and outcome of these patients was shown to be unfavorable. In 2009, the Intractable Hepato‒Biliary Diseases Study Group of Japan, Ministry of Health, Labour and Welfare proposed the guideline for prevention of liver injuries due to HBV reactivation, and the Japan Society of Hepatology had actively continued to develop the guideline and spread disease awareness. Fatal patients with acute liver failure, however, were enrolled in the nationwide survey even in the recent years. |