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  3. Impact of surveillance of hepatitis b and hepatitis c in patients with inflammatory bowel disease under anti-TNF therapies: Multicenter prospective observational study (REPENTINA 3)

Impact of surveillance of hepatitis b and hepatitis c in patients with inflammatory bowel disease under anti-TNF therapies: Multicenter prospective observational study (REPENTINA 3)

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Loras C
  • Gisbert JP
  • Saro MC
  • Piqueras M
  • Barrio J
  • Ordas I
  • Montserrat A
  • Ferreiro R
  • Zabana Y
  • Chaparro M
  • Fernandez-Banares F
  • Esteve M
  • REPENTINA study, GETECCU group (Grupo Espanol de trabajo de Enfermedades de Croh

Abstract

Aims: Assess IBD patients starting anti-TNF for the impact of preventive measures in HBV and/or HCV, and the predictive response factors to HBV vaccination. Methods: Multicenter prospective study including 389 IBD patients. Four interventions were established: I-1) anti-HBs <100 IU/L: HBV vaccination with double doses at 0-1-2 months, and revaccination if titres <100 IU/L (seroprotection defined as anti-HBs10-100 1U/L and effective vaccination anti-HBs >100 IU/L); I-2) anti-HBs >100 1U/L (previous effective vaccination): monitoring levels; I-3) anti-HBc and/or HCV+: analysis every two months; 1-4) HBsAg +: start anti-virals. Results: I-1 and I-2) For first vaccination, effective vaccination and seroprotection were obtained in 26.4% and 43.5%, and for revaccination 31.3% and 44.4%, respectively. Predictive factors of effective vaccination were age 30 years (OR = 2.2) and being vaccinated simultaneously with anti-TNF (OR = 5.2) instead of late vaccination, whereas age 30 years (OR = 2.6) and anti-TNF monotherapy (OR = 2.4) were predictive for seroprotection. 80.8% of patients previously vaccinated maintained titres at 29 months follow-up. The only factor related to maintaining titres was previous vaccination versus achieving effective vaccination during anti-TNF (HR = 2.49); I-3 and 1-4) HBV-DNA + without reactivation was detected in 7% of 29 anti-HBc. No reactivation was found in the remaining HCV (n = 5) or HBsAg (n = 4) patients. Conclusions: 1) Response to vaccination/revaccination is low in patients with anti-TNF. Young patients vaccinated at the beginning of anti-TNF and receiving it as a monotheraphy showed better response. 2) Long-lasting effective vaccination is greatest in patients previously vaccinated. 3) Following-up the established surveillance and/or preventive anti-viral therapy seems to be safe in HBV and HCV patients. (C) 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
1873-9946, 1876-4479

JOURNAL OF CROHNS & COLITIS  OXFORD UNIV PRESS

Tipo:
Article
Páginas:
1529-1538
PubMed:
25052345
Factor de Impacto:
1,676 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 38

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Keywords

  • Hepatitis B; Hepatitis C; Inflammatory bowel disease; Hepatitis B vaccination; Anti-TNF treatment

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