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Nina Kim, MD, MSc Editor Professor of Medicine Division of Allergy & Infectious Diseases University of Washington Disclosures : None Learning Objective Performance Indicators Recognize hepatitis B virus (HBV) reactivation, HBV flare, and HBV-associated liver failure Identify risk factors for HBV reactivation Implement HBV screening recommendations for patients at risk for HBV reactivation Provide HBV antiviral prophylaxis in selected individuals at risk for HBV reactivation Stratify risk of HBV reactivation based on hepatitis B serologic status and type of immunosuppressive therapy Background Hepatitis B virus (HBV) reactivation is a well-described clinical entity characterized by a rise in HBV DNA and typically followed by a rise in aminotransferase levels.[1] Although HBV reactivation can occur spontaneously or in the setting of hepatitis C virus (HCV) treatment, it is most commonly triggered by immunosuppression.[2] In addition, in persons receiving treatment for HBV, reactivation almost always occurs following withdrawal of HBV antiviral therapy