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Biologic Therapy Carries a Very Low Risk of Reactivation in Hepatitis B Surface Antigen-Negative Phase of Hepatitis B

2022; Volume: 34; Issue: 2 Linguagem: Inglês

10.5152/tjg.2022.22196

2148-5607

İlkay Ergenç, Haluk Tarık Kani, Murat Karabacak, Elif Cömert Özer, Shahin Mehdiyev, Fuad Jafarov, K. Abacar, S. Kutluğ Ağaçkiran, Gizem Sevik, Rahmi Aslan, Fatma Alıbaz-Öner, Nevsun İnanç, Pamir Atagündüz, Dilek Seçkin, Yeşim Özen Alahdab, Tülin Ergun, Haner Di̇reskeneli̇, Özlen Atuğ,

Hepatitis Viruses Studies and Epidemiology

Background: The risk of hepatitis B reactivation in hepatitis B surface antigen-negative phase of hepatitis B virus-infected patients exposed to biologic agents is not clear.We aimed to investigate the reactivation rate in hepatitis B surface antigen-negative phase of hepatitis B virus-infected patients after biologic therapy.Methods: Patients followed at gastroenterology, rheumatology, and dermatology clinics with a diagnosis of immune-mediated inflammatory diseases were screened.Immune-mediated inflammatory diseases patients exposed to biologic agents with a negative hepatitis B surface antigen and positive hepatitis B core immunoglobulin G antibody were included in the study.Results: We screened 8266 immune-mediated inflammatory disease patients, and 2484 patients were identified as exposed to biologic agents.Two hundred twenty-one patients were included in the study.The mean age was 54.08 ± 11.69 years, and 115 (52.0%) patients were female.The median number of different biologic subtype use was 1 (range: 1-6).The mean biologic agent exposure time was 55 (range: 2-179) months.One hundred and fifty-two (68.8%) patients used a concomitant immunomodulatory agent, and 84 (38.0%) patients were exposed to corticosteroids during biologic use.No hepatitis B reactivation with a reverse seroconversion of hepatitis B surface antigen positivity was seen.Antiviral prophylaxis for hepatitis B was applied to 48 (21.7%) patients.Hepatitis B virus-DNA was screened in 56 (25.3%) patients prior to the biologic exposure.Two patients without antiviral prophylaxis had hepatitis B virus-DNA reactivation with a negative hepatitis B surface antigen during exposure to the biologic agent.Conclusion: We found 2 reactivations and no hepatitis B surface antigen seroconversion in our cohort.Antiviral prophylaxis for patients exposed to biologic agents may need to be discussed in more detail.