Evaluation of HBV Reactivation and Antiviral Prophylaxis in Patients Receiving Immunosuppressive Therapy

Authors : Ahmet ŞAHİN, Selda ASLAN

Pages : 809-813

Doi:10.16899/jcm.1343166

View : 36 | Download : 44

Publication Date : 2023-09-30

Article Type : Research Paper

Abstract :Aim: Patients with chronic hepatitis B and people with a history of hepatitis B insert ignore into journalissuearticles values(HBV); infection are at risk of HBV reactivation insert ignore into journalissuearticles values(HBVr); when they receive immunosuppressive therapy. In this study, we aimed to evaluate the hepatitis B serology, risk groups and antiviral prophylaxis of patients receiving various immunosuppressive therapies due to rheumatological diseases. Material and Method: The study included 375 patients over 18 years of age who received tumor necrosis factor-α insert ignore into journalissuearticles values(TNF-α); inhibitor, tyrosine kinase inhibitor, steroids, methotrexate or anti-CD20 antibodies due to rheumatic diseases in a training and research hospital between May 2022 and May 2023. Hepatitis B surface antigen insert ignore into journalissuearticles values(HbsAg);, hepatitis B surface antibody insert ignore into journalissuearticles values(anti-Hbs);, hepatitis B core protein antibody insert ignore into journalissuearticles values(anti-Hbc IgG); serologies, immunosuppressive therapies and oral antivirals were retrospectively analyzed. Results: The average age of the 375 patients included in the study was 43.77±13.07 years. 193 insert ignore into journalissuearticles values(51.5%); of the patients were male. 11 patients were HbsAg positive, 150 patients were anti-Hbs positive, 19 patients were isolated anti-Hbc IgG positive, and 79 patients were both anti-Hbs and anti-Hbc IgG positive. According to serological findings, 109 insert ignore into journalissuearticles values(29%); patients had HBV exposure. All three test results of 194 insert ignore into journalissuearticles values(51.7%); patients were negative. A total of 85 insert ignore into journalissuearticles values(22.7%); patients received oral antiviral prophylaxis due to the use of immunosuppressive agents. In terms of HBVr, 16.5% were evaluated as high risk, 75.3% as moderate risk, and 8.2% as low risk. Out of 85 patients 79 received entecavir, 5 reveived tenofovir disoproxil fumarate insert ignore into journalissuearticles values(TDF); and 1 received tenofovir alafenamide fumarate insert ignore into journalissuearticles values(TAF);. The mean duration for the immunosuppressive therapy was 6.41±4.20 years. The mean duration of oral antiviral prophylaxis among patients was 1.02±1.72 years. HBVr was not observed in any of our patients. Conclusion: Before patients receive immunosuppressive therapy, hepatitis B serologies and prophylaxis indication should be evaluated firstly. In addition, as a preventive medicine activity, hepatitis B vaccinations of unvaccinated patients should be completed as quickly as possible.
Keywords : İmmünsupresyon, hepatit B, reaktivasyon