Are Patients with Different Rheumatologic Diseases Under Immunosuppressive Therapies Adequately Screened and Protected Against Viral Hepatitis?

Aim:The aim of this study is to determine the screening rates for hepatitis B (HBV) and C virus (HCV) in patients with rheumatologic diseases who receive immunosuppressive therapies, to evaluate the prevalence of HBV reactivation during the regimens and also to reveal the frequency of vaccination.Ma...

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Bibliographic Details
Main Authors: Gökçe KENAR, Mehmet Nedim TAŞ
Format: Article
Language:English
Published: Galenos Yayincilik 2022-06-01
Series:Namık Kemal Tıp Dergisi
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Online Access: http://namikkemalmedj.com/archives/archive-detail/article-preview/are-patients-with-different-rheumatologic-diseases/52170
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Summary:Aim:The aim of this study is to determine the screening rates for hepatitis B (HBV) and C virus (HCV) in patients with rheumatologic diseases who receive immunosuppressive therapies, to evaluate the prevalence of HBV reactivation during the regimens and also to reveal the frequency of vaccination.Materials and Methods:This retrospective study included the patients who were followed-up with different rheumatologic diseases in two rheumatology outpatient clinics. The immunosuppressive regimens were categorized into two groups as biologic (bDMARDs) and conventional synthetic disease modifying anti rheumatic drugs (csDMARDs). The markers of HBsAg, anti-HBs, anti-HBc-IgM and anti-HBc-IgG, HBV DNA, anti-HCV levels were all taken from the patients’ charts checked prior and during the immunosuppressive treatments.Results:There were 451 patients [61.9% female, mean age 41.1 years, (standard deviation: 13.78)] who were taking bDMARDs (n=348) and csDMARDs (n=103). The data for HBV for 20 (4.4%) patients and HCV for 23 (5%) patients were missing, all in the csDMARDs group. Also, HBV serology tests were found to be incomplete in 51 patients (14.7%) in the bDMARDs group, as not checking the anti-HBc-IgM and anti-HBc-IgG. During the follow-up, HBV reactivation was not observed in the whole cohort. In the bDMARDs group, there were 39 patients who did not receive prophylaxis despite having HBsAg negative phase of chronic HBV infection; no HBV reactivation was observed also in this group. One hundred twenty nine (28.6%) of the patients were evaluated as never infected and unvaccinated prior to immunosuppressive therapies. Recurrent HBV serology controls were performed in nearly half (n=75) of them during their follow-up and it was observed that all were still non-immune.Conclusion:The screening rates of HBV and HCV serology were detected as successful in rheumatology patients under immunosuppressive therapies. No HBV reactivation was observed in the entire group. Also, the study showed that there was a significant deficiency in immunizing patients against HBV in follow-up.
ISSN:2587-0262