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Risk of hepatitis B reactivation during anti-TNF therapy; evaluation of patients with past hepatitis B infection

Volume 31 · Issue 7 Publish Date: July 15, 2020
Süleyman Sayar Kemal Kürbüz Resul Kahraman Oğuzhan Öztürk Zuhal Çalışkan Hamdi Levent Doğanay Kamil Özdil
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Turkish Journal of Gastroenterology

Volume 31 · Issue 7

Pages: 522-528

History

Published Online: July 15, 2020

Copyright © 2020 Süleyman Sayar, Kemal Kürbüz, Resul Kahraman, Oğuzhan Öztürk, Zuhal Çalışkan, Hamdi Levent Doğanay, Kamil Özdil

Süleyman Sayar
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Kemal Kürbüz
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Resul Kahraman
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Oğuzhan Öztürk
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Zuhal Çalışkan
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Hamdi Levent Doğanay
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Kamil Özdil
Department of Gastroenterology, Ümraniye Training and Research Hospital, İstanbul
Sayar, S., Kürbüz, K., Kahraman, R., Öztürk, O., Çalışkan, Z., Doğanay, H. L., & Özdil, K. (2020). Risk of hepatitis B reactivation during anti-TNF therapy; evaluation of patients with past hepatitis B infection. Turkish Journal of Gastroenterology, 31(7), 522–528. https://doi.org/10.5152/tjg.2020.19295
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Abstract

Background/Aims: Hepatitis B reactivation (HBVR) is an important risk of treatment with tumor necrosis factor inhibitors (anti-TNF). While antiviral prophylaxis is recommended before treatment in HBsAg-positive patients, there is no clear approach for the follow-up or prophylactic treatment of patients with past hepatitis B virus (HBV) infection. The aim of this study was to evaluate patients with past HBV infection treated with anti-TNF for HBVR and/or HBVR-associated biochemical breakthrough. Material and Methods: Patients who received anti-TNF therapy and had past HBV infection (HBsAg negative, anti-HBc IgG positive, anti-HBs negative or positive) were screened and evaluated at 3-month intervals for viral and biochemical breakthrough according to a liver function test (ALT) and HBV DNA level. Results: A total of 653 patients who received anti-TNF therapy were screened. Ninety of these patients had past HBV infection and had not received antiviral prophylaxis. Anti-HBs positivity and isolated anti-HBc IgG positivity were seen in 87.7% (n: 79) and 12.2% (n: 11) of these patients, respectively. No HBVR was seen in 20% (n: 18) of patients who were followed up regularly, and no HBVR-associated biochemical breakthrough was found in patients who were not followed up regularly in terms of HBV DNA level (80%, n: 72) during the follow-up period (26±16 months). Conclusion: The use of anti-TNF in patients with past HBV infection has a low risk for HBVR. A follow-up for the ALT and HBV DNA levels at 3-month intervals may be more reasonable than administering antiviral prophylaxis to all patients.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 31 · Issue 7
Pages 522-528
DOI 10.5152/tjg.2020.19295
History
Published Online July 15, 2020
Copyright
Copyright (c) 2020 Süleyman Sayar, Kemal Kürbüz, Resul Kahraman, Oğuzhan Öztürk, Zuhal Çalışkan, Hamdi Levent Doğanay, Kamil Özdil
Affiliations
Süleyman Sayar
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Kemal Kürbüz
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Resul Kahraman
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Oğuzhan Öztürk
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Zuhal Çalışkan
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Hamdi Levent Doğanay
Health Sience University, Umraniye Research And Education Hospital-Gastroenterology
Kamil Özdil
Department of Gastroenterology, Ümraniye Training and Research Hospital, İstanbul
Cite this Article
Sayar, S., Kürbüz, K., Kahraman, R., Öztürk, O., Çalışkan, Z., Doğanay, H. L., & Özdil, K. (2020). Risk of hepatitis B reactivation during anti-TNF therapy; evaluation of patients with past hepatitis B infection. Turkish Journal of Gastroenterology, 31(7), 522–528. https://doi.org/10.5152/tjg.2020.19295
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