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Risk of hepatitis B reactivation in patients receiving anti‐tumor necrosis factor‐α therapy
Ist Teil von
International journal of rheumatic diseases, 2021-02, Vol.24 (2), p.254-259
Ort / Verlag
England: Wiley Subscription Services, Inc
Erscheinungsjahr
2021
Quelle
Wiley Blackwell Single Titles
Beschreibungen/Notizen
Objective
The purpose of this study was to determine hepatitis B virus (HBV) screening rates in patients receiving anti‐tumor necrosis factor (TNF)‐α therapy and the frequency of HBV reactivation in patients with resolved hepatitis B virus infection (hepatitis B surface antigen [HBsAg] negative, hepatitis B core antibody [Anti‐HBc] positive).
Patients and methods
Data from 1834 patients who underwent anti‐TNF‐α therapy in the Rheumatology, Gastroenterology and Dermatology Departments of our hospital between 2010 and 2020 were retrospectively analyzed. Within 6 months before the initial anti‐TNF‐α therapy, performing a HBsAg and/or anti‐HBc test is defined as HBV screening. HBV reactivation is defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive.
Results
The overall HBV screening rate was 82.3% before starting anti‐TNF‐α therapy. There was an increasing trend in HBV screening rates during the years analyzed (64% in 2010, 87.4% in 2019) (P < .001). Before anti‐TNF‐α therapy was initiated, 272 patients were HBsAg negative and anti‐HBc positive. Among these patients, HBV reactivation did not occur in 31 patients who received antiviral prophylaxis, whereas HBV reactivation occurred in only 1 (0.4%) of the 241 patients who did not receive antiviral prophylaxis.
Conclusion
Hepatitis B virus screening rates prior to starting anti‐TNF‐α therapy were relatively high, and its trend was increased by year. HBV reactivation because of anti‐TNF‐α use rarely occurred in patients with resolved HBV infection. Further studies are needed on whether routine anti‐HBc screening and/or HBV DNA follow‐up are necessary in these patients aside from HBsAg.