PMID- 30260778
OWN - NLM
STAT- MEDLINE
DCOM- 20190219
LR  - 20200225
IS  - 2148-5607 (Electronic)
IS  - 1300-4948 (Print)
IS  - 1300-4948 (Linking)
VI  - 29
IP  - 5
DP  - 2018 Sep
TI  - Reactivation rates in patients using biological agents, with resolved HBV 
      infection or isolated anti-HBc IgG positivity.
PG  - 561-565
LID - 10.5152/tjg.2018.18032 [doi]
AB  - BACKGROUND/AIMS: Tumor necrosis factor-alpha (TNF-alpha) inhibitors and ustekunimab are 
      widely used in autoimmune diseases. It is known that these biological agents 
      cause the reactivation of hepatitis B virus (HBV). There is no standardized 
      strategy to prevent the reactivation in patients with evidence of a previous HBV 
      infection. In our study, anti-HBc IgG-positive patients who received a biological 
      agent were evaluated in terms of HBV reactivation. MATERIALS AND METHODS: 
      Patients who were followed up for the use of biological agents in our clinic were 
      evaluated retrospectively. Patients with isolated anti-HBc IgG positivity were 
      included in the study. The HBV reactivation data were recorded from the patients' 
      files retrospectively. RESULTS: Two hundred and seventy-eight patients who 
      received biological treatment were evaluated. Twenty-nine patients with isolated 
      anti-HBc IgG positivity or resolved HBV infection were included in the study. The 
      HBV reactivation was seen in 5 patients (17.2%). Of these patients, 3 were using 
      adalimumab, 1 infliximab, and 1 ustekunimab. It was controlled by antiviral 
      therapy that was started in the early period. CONCLUSION: Drugs that block TNF-alpha 
      and ustekunimab cause an increase in viral replication. In literature, the HBV 
      reactivation rate was approximately 1% in HBsAg-negative, anti-HBC IgG-positive 
      cases, whereas it was found to be as high as 17.2% in our study. Patients 
      receiving the immunomodulator therapy should be evaluated for HBV serology before 
      treatment and carefully monitored for HBV reactivation during and after 
      treatment.
FAU - Solay, Asli Haykir
AU  - Solay AH
AD  - Department of Infection Disease and Clinical Microbiology, Health Sciences 
      University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, 
      Turkey.
FAU - Acar, Ali
AU  - Acar A
AD  - Department of Infection Disease and Clinical Microbiology, Health Sciences 
      University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, 
      Turkey.
FAU - Eser, Fatma
AU  - Eser F
AD  - Department of Infection Disease and Clinical Microbiology, Health Sciences 
      University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, 
      Turkey.
FAU - Kuscu, Ferit
AU  - Kuscu F
AD  - Department of Infection Disease and Clinical Microbiology, Cukurova University 
      School of Medicine, Adana, Turkey.
FAU - Tutuncu, Emin Ediz
AU  - Tutuncu EE
AD  - Department of Infection Disease and Clinical Microbiology, Health Sciences 
      University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, 
      Turkey.
FAU - Kul, Gulnur
AU  - Kul G
AD  - Department of Infection Disease and Clinical Microbiology, Health Sciences 
      University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, 
      Turkey.
FAU - Senturk, Gonul Cicek
AU  - Senturk GC
AD  - Department of Infection Disease and Clinical Microbiology, Health Sciences 
      University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, 
      Turkey.
FAU - Gurbuz, Yunus
AU  - Gurbuz Y
AD  - Department of Infection Disease and Clinical Microbiology, Health Sciences 
      University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, 
      Turkey.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - Turkey
TA  - Turk J Gastroenterol
JT  - The Turkish journal of gastroenterology : the official journal of Turkish Society 
      of Gastroenterology
JID - 9515841
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Antiviral Agents)
RN  - 0 (Biological Factors)
RN  - 0 (Hepatitis B Antibodies)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - B72HH48FLU (Infliximab)
RN  - FU77B4U5Z0 (Ustekinumab)
RN  - FYS6T7F842 (Adalimumab)
SB  - IM
MH  - Adalimumab/adverse effects
MH  - Antirheumatic Agents/*adverse effects
MH  - Antiviral Agents/therapeutic use
MH  - Biological Factors/*therapeutic use
MH  - Female
MH  - Hepatitis B/drug therapy/immunology/*virology
MH  - Hepatitis B Antibodies/blood
MH  - Hepatitis B virus/*physiology
MH  - Humans
MH  - Infliximab/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Tumor Necrosis Factor-alpha/antagonists & inhibitors
MH  - Ustekinumab/*adverse effects
MH  - Virus Activation/*drug effects
PMC - PMC6284614
COIS- Conflict of Interest: The authors have no conflict of interest to declare.
EDAT- 2018/09/28 06:00
MHDA- 2019/03/21 06:00
PMCR- 2018/09/01
CRDT- 2018/09/28 06:00
PHST- 2018/09/28 06:00 [entrez]
PHST- 2018/09/28 06:00 [pubmed]
PHST- 2019/03/21 06:00 [medline]
PHST- 2018/09/01 00:00 [pmc-release]
AID - tjg-29-5-561 [pii]
AID - 10.5152/tjg.2018.18032 [doi]
PST - ppublish
SO  - Turk J Gastroenterol. 2018 Sep;29(5):561-565. doi: 10.5152/tjg.2018.18032.