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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, …
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.
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