Nationwide Study Tracks Hepatitis B Reactivation and Liver Dysfunction

A nationwide real-world study is examining hepatitis B virus (HBV) reactivation and liver dysfunction risk in Chinese patients with inflammatory bowel disease (IBD) treated with infliximab. IBD—Crohn’s disease and ulcerative colitis—is rising globally, and China is highlighted due to changing diets, urbanization, environmental exposures and better diagnosis. Infliximab, a widely used anti–TNF-α biologic, improves intestinal inflammation and can reduce steroid dependence, hospitalizations and surgeries. But TNF-α also supports immune defense, so suppressing it may allow controlled infections to re-emerge. The study focuses on HBV reactivation, which can lead to severe hepatitis, liver failure and, in extreme cases, death, particularly when immune control weakens during immunosuppressive therapy. China’s intermediate HBV endemicity and estimated 70 million chronic carriers mean many starting biologics may have chronic infection or past exposure. The research aims to mirror routine clinical practice across multiple centers rather than highly selected trial conditions.