Akademik Veri Yönetim Sistemi
APASL 2017, Shangai, Çin, 15 - 19 Şubat 2017, ss.715-716
Background: The individuals who faced with hepatitis B virus (HBV) infection are under risk of HBV reactivation when their immunities are being suppressed (1, 2). In the current study, we aimed to evaluate the outcomes of HBV infection and importance of administration of prophylactic antiviral using in patients under immunosuppresive treatment.
Methods: This study was conducted at Karadeniz Technical University, Farabi Hospital, between 01.01.2010 and 30.10.2016. The patients above 18 years who have HBsAg positivity or HBsAg negativity but Anti-Hbc IgG positivite and are being taken or planned immunosuppressive treatment were included into study. The patients were followed by liver function tests monthly and HBV-DNA measurements in every three months.
Result: Sixty-three patients were included into study. Thirty-three (52.3%) of male, 30 (47.6%) of female. Mean age of patients were 52.16 ± 14.95 (24–86). Fifty-four (85.7%) of the patients had HBsAg and Anti-HBc IgG positivity with Anti-HBs negativity. HBsAg was negative and Anti-HBc IgG positive in 8 patients however 2 of them had Anti-HBs positivity and remaining was negative. HBV prophylaxis was started in total 48 (76%) patients with parallel to their immunosuppresive tratment however timing of prophylaxis was not true in 15 (24%) patients. Properties of the patients was given in Table. Lamivudine, tenofovir and entecavir were used in 46 (73%), 11 (17.4%), and 6 (9.5%) patients as prophylaxis regimen, respectively. Eight (72.7%) of tenofovir patients had lamivudine experience. HBV reactivation was developed due to prophylaxis delay in 3 patients, incompatibility and negligence in 2 patients. The patient whose prophylaxis was negclected died from HBV reactivation. Fifty (79.3%) patients continued to take prophylaxis at the end of 6 months follow-up period. At the end of 6th months, HBV-DNA levels were above the 2000 IU/mL in three patients however their HBVDNA levels were detected as negative six months later. At the 12th month; HBV reactivation were detected in 2 patients which had negative HBV-DNA result at 6th month. Reactivation was seen in one patient as treatment incompatibility. HBV-DNA were detected as negative in all remaining patients.
Conclusion: Our study show that timely starting antiviral prophylaxis is very important to prevent HBV reactivation in which patients under immunosuppressive treatment. It should keep in mind that an overdue for the prophylaxis can lead to mortality.
References 1. Tavakolpour S, Alavian SM, Sali S. Hepatitis B Reactivation During Immunosuppressive Therapy or Cancer Chemotherapy, Management, and Prevention: A Comprehensive Review-Screened. Hepat Mon. 2016; 26;16 (4):e35810. 2. Sagnelli E, Pisaturo M, Martini S, et al. Clinical impact of occult hepatitis B virus infection in immunosuppressed patients. World J Hepatol. 2014; 2