Hepatitis b virus (HBVr) reactivation may occur in patients treated with immunosuppressive therapy and chemotherapy. Therefore, in the current biological age, it is important for physicians to understand the risk of hepatitis B virus reactivation in patients with autoimmune disease undergoing anti-cytokine therapy.

Chronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of progressive liver disease and death worldwide. Although considered benign infections in childhood, their persistence into adulthood is certainly a cause for concern.

Improvements in hepatitis B virus (HBV) treatment have been modest. Investigational anti-HBV agents are considered based on pediatric pathophysiology, including capsid assembly modifiers, antigen secretion inhibitors, silencing RNAs, and immune modulators. Recommendations for screening and treatment of hepatitis B in children with risk factors or comorbidities have also been established.

The main cause of hepatitis B in children is mother-to-child transmission. In fact, in Asian countries, this is a common route of transmission of hepatitis B because people's knowledge about the disease is limited, and many people are not fully vaccinated. In Vietnam, many women have not been screened for the disease before and during pregnancy. According to some studies, in Vietnam, more than 10% of pregnant women are infected with the hepatitis B virus. This is a very high rate.

Current drugs against HBV have inherent limitations. NAs are safe and well tolerated and are generally successful in suppressing replication. They are not curative, as they act late in the viral cycle and do not prevent the persistence of HBV-DNA in integrated or episodic forms.

As all professional societies recommend in their guidelines, patients with chronic HBV should receive antiviral prophylaxis when they start non-TNF-targeted biologics. In patients with resolved HBV, the rates of HBV reactivation without antiviral prophylaxis in patients receiving IL-23, IL-17, and JAK inhibitors were up to 2.3%, 4.2%, and 0%, respectively.