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Hepatitis B reactivation: reducing the risk in patients with inflammatory bowel disease
  1. Grace Elizabeth Dolman,
  2. Patrick T F Kennedy
  1. Barts Liver Centre, Barts and The London School of Medicine and Dentistry, London, UK
  1. Correspondence to Prof Patrick T F Kennedy, Barts Liver Centre, Barts and The London School of Medicine and Dentistry, London E1 2AT, UK; p.kennedy{at}

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We would like to congratulate Lamb et al for the production of such a comprehensive guideline for the management of inflammatory bowel disease (IBD).1 Further clarification is warranted regarding screening for hepatitis B virus (HBV) prior to immunosuppression and subsequent management to reduce the risk of virus reactivation.

The guidelines recommend screening for HBV at diagnosis and before immunomodulatory/biologic therapies. We strongly recommend that screening includes hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B surface antigen (anti-HBs) as outlined in the European Crohn’s and Colitis Organisation Opportunistic Infections Consensus.2 Lamb et al advise seeking specialist input prior to commencing immune-modifying therapy for those patients with active HBV (i.e. HBsAg positive). In line with national and international guidelines, …

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  • Contributors GED proposed the letter and prepared the initial draft. PTFK edited the letter and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.