IBD prevalence in HBV patients similar to that of general population
The prevalence of hepatitis B virus infection among patients with inflammatory bowel disease in Hong Kong was similar to that of the general population, according to recent findings published in BMC Gastroenterology.
Heyson C.H. Chan, MBChB, MRCP, in the department of medicine and therapeutics at the Institute of Digestive Disease, Chinese University of Hong Kong, and colleagues performed a retrospective study of 406 adult patients diagnosed with IBD, including those with Crohn’s disease (n = 185) and ulcerative colitis (n = 221) at Prince of Wales Hospital. The researchers assessed HBV prevalence as well as determinants of altered transaminases, effects of HBV on therapeutic strategy and IBD clinical course.
They found an IBD prevalence of 5.7% in the HBV population, which was comparable to the rate of about 7% among the general population. Steroid use (OR = 2.52; 95% CI, 1.394-6.45) and history of surgery (OR = 2.33; 95% CI, 1.107-4.906) were associated with altered transaminases in IBD. In addition, there was no significant difference in disease control or IBD medication use between hepatitis B surface antigen-positive and negative patients with IBD.
The researchers wrote that the risk for HBV reactivation was low in patients receiving immunosuppressive therapy from thiopurines, unless there was concomitant steroid use.
“This finding echoes the recent updated American Gastroenterological Association guideline which recommends that only patients at moderate to high risk undergoing immunosuppressive therapy should have antiviral prophylaxis,” the researchers wrote. “Based on our results and the latest AGA recommendation, we suggest that close monitoring of liver function and prompt initiation of antiviral in case of altered transaminases may be a reasonable option for IBD patients with HBV treated with thiopurines.” – by Will OffitDisclosure: The researchers report no relevant financial disclosures.