Volume : IX, Issue : IV, April - 2020

Prevalence of Occult hepatitis B in rheumatologic patients on and before starting immunosuppressants

Arun P, A R Venketeshwaran, Premkumar K

Abstract :

Background: Occult hepatitis B infection is characterized by negative hepatitis B surface antigen (HBsAg) and also detectable hepatitis B virus (HBV) DNA, with or without hepatitis B core antibody (anti–HBc). HBV reactivation in individuals under immunosuppressive therapy is critical as they are prone for fulminant liver failure and hepatitis flare. Aim and Objectives: The aim of this cross sectional observational study is to assess the prevalence of occult hepatitis B infection in patients having rheumatologic disorders on immunosuppressant and also in immunosuppressant naïve patients. Materials and methods: This study was done in patients admitted in Institute of Rheumatology during the time period of July 2018–December 2018. Patients having or planned to be started on biologicals ,TnF alpha inhibitors , prednisolone more than 20mg for 4 weeks were evaluated. Investigations for screening for occult hepatitis B (HBsAg,Total antiHbC) was send .HBV DNA as screening for occult infection was not due to financial constraints. Results: 50 patients were investigated in a similar manner.18 (36%) cases turned out to be Total Anti Hbc positive and HbsAg negative. One of patients on Rituximab had reactivation in form of HBsAg positivity and Total Anti HBc positivity.10 cases which were harboring occult infection were on TnF alpha blockers, 1 on Rituximab, 5 on cyclophosphamide, 2 on high dose of steroid for lupus flare. Total 3 of the patients had history of blood transfusion in past. Mean age was 32– Conclusion: Prevalence of occult hepatitis B in our study population when compared with other studies (3–7%) is very high (36%). Screening for occult hepatitis B with HbsAg, Total Anti Hbc and HBV DNA should be made mandatory before starting patients on immunosuppressants.

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Article: Download PDF    DOI : 10.36106/ijsr  

Cite This Article:

PREVALENCE OF OCCULT HEPATITIS B IN RHEUMATOLOGIC PATIENTS ON AND BEFORE STARTING IMMUNOSUPPRESSANTS, Arun P, A R Venketeshwaran, Premkumar K INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-9 | Issue-4 | April-2020

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