Hepatitis B Reactivation and Antiviral Prophylaxis in Patients on Immunosuppressive Therapy İmmünosüpresif Tedavi Alan Hastalarda Hepatit B Reaktivasyonu ve Antiviral Profilaksi
Viral Hepatitis Journal, cilt.31, sa.3, ss.91-96, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 31 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/vhd.galenos.2026.2025-10-1
- Dergi Adı: Viral Hepatitis Journal
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.91-96
- Anahtar Kelimeler: Anti-HBc-positive, antiviral prophylaxis, corticosteroids, HBsAg positive, immunosuppressive therapy, rituximab
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: Hepatitis B virus reactivation (HBVr) may occur in patients receiving immunosuppressive therapy. The risk of HBVr varies depending on the immunosuppressive agent used and hepatitis serology. This study aimed to evaluate HBVr among immunosuppressed patients with and without antiviral prophylaxis. Materials and Methods: HB surface antigen (HBsAg)positive and/or HB core antibody-positive patients receiving immunosuppressive therapy were retrospectively evaluated at a single-center, tertiary-care hospital. Results: A total of 224 patients were initially screened, and 153 were included in the study. The median age was 62 years (range, 52.5-72), and 50.3% were female. The rate of HBsAg positivity was 21.6%, while HB surface antibody positivity was detected in 52.3% of patients. Antiviral prophylaxis was administered to 81.7% of patients: entecavir (75.2%), tenofovir disoproxil fumarate (TDF) (19.2%), and tenofovir alafenamide (TAF) (5.6%). HBVr was not observed in patients receiving antiviral prophylaxis, whereas two cases occurred in patients not receiving prophylaxis (p=0.033). One of these patients was receiving rituximab-based therapy, and the other was on corticosteroid treatment. When patients were stratified by risk group, rates of HBVr among patients who did not receive prophylaxis were 50% in the high-risk group, 25% in the moderate-risk group, and 0% in the low-risk group. Conclusion: HBVr may occur in immunosuppressed patients. In these patient groups, hepatitis serologic testing should be performed, and antiviral prophylaxis should be administered according to the immunosuppressive regimen. Entecavir, TDF, and TAF appear to be both effective and safe. Patients without antiviral prophylaxis should be closely monitored.