Journals / Turkish Journal of Gastroenterology / 2018 / Cilt: 29 - Sayı: 5

Reactivation rates in patients using biological agents, with resolved HBV infection or isolated anti-HBc IgG positivity

Pages
561–565
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In literature, the HBV reactivation rate was approximately 1% in HBsAg-negative, anti-HBC IgG-positive cases, whereas it was found to be as high as 17.2% in our study.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/Aims: Tumor necrosis factor-α (TNF-α) inhibitors and ustekunimab are widely used in autoimmune diseases.
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Key Findings & Data:There is no standardized strategy to prevent the reactiva-tion in patients with evidence of a previous HBV infection.
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Conclusion & Impact:In literature, the HBV reactivation rate was approximately 1% in HBsAg-negative, anti-HBC IgG-positive cases, whereas it was found to be as high as 17.2% in our study.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Background/Aims: Tumor necrosis factor-α (TNF-α) inhibitors and ustekunimab are widely used in autoimmune diseases. It is known that these biological agents cause the reactivation of hepatitis B virus (HBV). There is no standardized strategy to prevent the reactiva-tion in patients with evidence of a previous HBV infection. In our study, anti-HBc IgG-positive patients who received a biological agent were evaluated in terms of HBV reactivation. Materials and Methods: Patients who were followed up for the use of biological agents in our clinic were evaluated retrospectively. Pa-tients with isolated anti-HBc IgG positivity were included in the study. The HBV reactivation data were recorded from the patients’ files retrospectively. Results: Two hundred and seventy-eight patients who received biological treatment were evaluated. Twenty-nine patients with isolated anti-HBc IgG positivity or resolved HBV infection were included in the study. The HBV reactivation was seen in 5 patients (17.2%). Of these patients, 3 were using adalimumab, 1 infliximab, and 1 ustekunimab. It was controlled by antiviral therapy that was started in the early period. Conclusion: Drugs that block TNF-α and ustekunimab cause an increase in viral replication. In literature, the HBV reactivation rate was approximately 1% in HBsAg-negative, anti-HBC IgG-positive cases, whereas it was found to be as high as 17.2% in our study. Patients receiving the immunomodulator therapy should be evaluated for HBV serology before treatment and carefully monitored for HBV reac-tivation during and after treatment.

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Cite This Article

SOLAY, A. H., ACAR, A., ESER, F., KUŞCU, F., TÜTÜNCÜ, E. E., KUL, G., ŞENTÜRK, G. Ç., GÜRBÜZ, Y. (2018). Reactivation rates in patients using biological agents, with resolved HBV infection or isolated anti-HBc IgG positivity. Turkish Journal of Gastroenterology, Cilt: 29 - Sayı: 5, 561–565. https://ajindex.com/articles/410070

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References (2)

  1. Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg se- roprevalence and endemicity. Vaccine 2012; 30: 2212-9. [CrossRef] Carroll MB, Forgione MA. Use of tumor necrosis factor α inhibitors in hepatitis B surface antigen-positive patients: a literature review and potential mechanisms of action. Clin Rheumatol 2010; 9: 1021-9. [CrossRef] Lee YH, Bae SC, Song GG. Hepatitis B virus (HBV) reactivation in rheumatic patients with hepatitis core antigen (HBV occult carriers) undergoing anti-tumor necrosis factor therapy. Clin Exp Rheumatol 2013; 31: 118. Biondo MI, Germano V, Pietrosanti M, et al. Lack of hepatitis B virus reactivation after anti-tumour necrosis factor treatment in po- tential occult carriers with chronic inflammatory arthropathies. Eur J Intern Med 2014; 25: 482-4. [CrossRef] Cansu DU, Temel T, Erturk A, Kasifoglu T, Acu B, Korkmaz C. The long-term effects of anti-TNF-α agents on patients with chronic viral hepatitis C and B infections. Int J Rheum Dis 2015; 18: 40-5. [CrossRef] Herbein G, O’Brien WA. Tumor necrosis factor (TNF)-alpha and TNF receptors in viral pathogenesis. Proc Soc Exp Biol Med 2000; 223: 241-57. [CrossRef] Nard FD, Todoerti M, Grosso V et al. Risk of hepatitis B virus reac- tivation in rheumatoid arthritis patients undergoing biologic treat- ment: Extending perspective from old to newer drugs. World J Hepa- tol 2015; 7: 344-61. [CrossRef] Perrillo RP, Gish R, Falck-Ytter YT. American Gastroenterological Association Institute Technical Review on Prevention and Treatment of Hepatitis B Virus Reactivation During Immunosuppressive Drug Therapy. Gastroenterology 2015; 148: 221-44. [CrossRef] Kalfa M, Aksu K. Treatment with tumor necrosis factor-alpha an- tagonists and infections. RAED Journal 2011; 3: 49-56. Koc E. Ustekunimab. Turkderm - Arch Turk Dermatol Venerology 2016; 50: 43-5.
  2. Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT; Amer- ican Gastroenterological Association Institute. American Gastroenter- ological Association Institute guideline on the prevention and treat- ment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology 2015; 148: 215-9. [CrossRef] Shih C-A, Chen W-C, Yu H-C, et al. Risk of severe acute exac- erbation of chronic HBV infection cancer patients who underwent chemotherapy and did not receive anti-viral prophylaxis. PLoS One 2015; 10: e0132426. [CrossRef] Wai-Kay Seto. Hepatitis B viru