Abstract

INTRODUCTION: HBV reactivation (HBVr) is a well-known complication in patients receiving immunosuppressive therapy and leads to significant morbidity and mortality. As the use of biological agents becomes more common in rheumatology practice, a growing number of HBVr cases are reported. The aim of this study was to evaluate the awareness of rheumatologists about the risk of HBVR, pre-treatment screening and prophylactic treatment in patients receiving immunosuppressive therapy.The aim of our study was to evaluate the awareness of rheumatologists about the risk of HBVR, pre-treatment screening and prophylactic treatment in patients receiving immunosuppressive therapy.

METHODS: All rheumatyology specialist members of the Turkish Association of Rheumatology were invited to the study between April 1 and June 30, 2018. An e-mail was sent to the participants 3 times once in a month with an informative message, with a link to the questionnaire that allows the survey to be completed only once. Inclusion criteria were to be a member of Turkish Rheumatology Association and to be a rheumatology specialist as an active clinician in Turkey. The results of the survey were evaluated by the researchers.

SONUÇLAR: A questionnaire was sent to 270 rheumatologists who met the criteria, 48 (%17,8) questionnaires were completed and included in the study. Participants had an average of 6.5 (1-25) years of professional experience. 93.8% (45/48) of the rheumatologists thought that all patients should be screened for HBV before immunosuppressive treatment and 6.2% thought that HBV screening should be performed only in high-risk patients. In patients with high-risk immunosuppressive therapy, such as Rituximab screening rate for HBV was %95,8 (46/48) but in patients with low risk such as less than 10 mg of prednisolone and their equivalent for more than 4 weeks screening rate was %35,4(17/48). When selecting an initial screening test; all of the rheumatologists (48/48) checked the HBsAg and %83,3 (40/48) would checked also HBcIgG and antiHBs. 44 (91.7%) rheumatologists stated that he or she had at least one patient with prophylaxis. Tenofovir (84.1%) was most commonly used drug in prophylaxis. 14 (29.2%) rheumatologists stated that HBVr was detected in at least one patient and 11of them stated that they had patients whose rheumatologic therapies were interrupted because of HBVr. 

TARTIŞMA ve SONUÇ: The results of our study show that the awareness of rheumatologists about HBV reactivation is relatively high but there is a need to further improvement.