Department of Paediatrics, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong SAR, China
WH Chan(陳偉雄)*# MBChB, MRCP, FHKAM(Paed)
WKY Chan(陳桂如) FHKAM(Paed)
CH Ng(吳志恒) FHKAM(Paed)
SMY Wong(黃敏儀) FHKAM(Paed)
Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China
MYW Kwan(關日華)*# FHKCPaed, FHKAM(Paed), MSc(Applied Epidemiology) CUHK
DWY Mak(麥偉猷) MBBS(HK), MRCPCH, FHKAM(Paed)
EKC Yau(丘健昌) MBBS(HK), MRCPCH, FHKAM(Paed)
Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong SAR, China
DC Lung(龍振邦)* MBBS, MRCPCH, FRCPath
Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Road, Yaumatei, Kowloon, Hong Kong SAR, China
MC Chan(陳美貞) FHKAM(Paed)
Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong SAR, China
FWT Cheng(鄭偉才) MD(CUHK), FHKCPaed, FHKAM(Paed)
TL Ku(古德來) FHKAM(Paed)
Department of Paediatrics, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong SAR, China
CM Chow(周中武) MB ChB(CUHK), FHKCPaed, FHKAM(Paed)
ACH Ho(何志恆) FHKAM(Paed)
Paediatric Nephrology Center, Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong SAR, China
WM Lai(賴偉明) FHKCP, FHKAM(Paed), FRCPCH(UK)
Clinical Pharmacy, Hong Kong Children's Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong SAR, China
FMH Poon(潘文康) M Clin Pharm, B Pharm(Hons)
Department of Neonatal Intensive Care Unit, Hong Kong Children's Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong SAR, China
RMS Wong(黃明沁) FHKAM(Paed)
Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, 23 Tsing Chung Koon Road, Tuen Mun, N.T., Hong Kong SAR, China
SN Wong(黃錫年) MBBS(HK), FHKAM(Paed), FRCPCH
Department of Internal Medicine, Union Hospital, 18 Fu Kin Street, Tai Wai, Shatin, N.T.; and Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
HLY Chan(陳力元) MD(CUHK), FRCP(Lond), FHKAM(Med)
Department of Pediatrics, College of Medicine - National Taiwan University Hospital, Taiwan
MH Chang(張美惠) MD
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatrics, National Taiwan University Hospital, Taiwan
JF Wu(吳嘉) MD, PhD
Department of Infectious and Liver Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
XB Xie(謝新寶) MD
Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong SAR, China
YL Lau(劉宇隆) MD(Hons)
Department of Paediatrics and Adolescent Medicine, Alice Ho Miu Ling Nethersole Hospital, 11 Chuen On Road, Tai Po, N.T., Hong Kong SAR, China
KC Chan(陳國超)# FRCPCH, FHKCPaed, FHKAM(Paed)
*Denotes authors contributed equally to the work and share the first authorship
#Denotes authors contributed equally to the work and share the corresponding authorship
Correspondence to: Dr WH Chan, Dr MYW Kwan, Dr KC Chan
Email: cwhz01@ha.org.hk;kwanyw1@ha.org.hk ;chankc@ha.org.hk
Received February 4, 2021
Hepatitis B reactivation can be a fatal complication of paediatric hepatitis B patients receiving immunosuppressive therapy. However, there is no specific recommendation in paediatric patient group. This article aims to summarize the paediatric recommendations from international guidelines with reference to Hong Kong SAR paediatric data. Hepatitis B reactivation risk is stratified into "high risk group", "moderate risk group" and "low risk group". All paediatric patients who will receive immunosuppressive therapy in moderate and high risk groups should be tested for hepatitis B surface antigen and antibody to hepatitis B core antigen prior to receiving treatment. Hepatitis B deoxyribonucleic acid (HBV DNA) level should be checked if the patients' either test is positive. Antiviral prophylaxis should be given in high risk group patients. Antiviral prophylaxis should be considered in moderate risk group patients. Hepatitis B screening tests and antiviral prophylaxis are not recommended in low risk group. Entecavir and Tenofovir disoproxil fumarate are drugs of choice.
