Risk of hepatitis B virus reactivation during immunosuppressive treatment

OBJECTIVE: In this study, we aimed to rate Hepatitis B Virus (HBV) reactiva-tion, risk factors for reactivation and compare the efficacy of prophylactic antiviral therapy in pa-tients who initiated immunosuppressive therapy.PATIENTS AND METHODS: A total of 177 patients with Chronic Hepatitis B or resolved HBV infection who had received immunosup-pressive treatment were analyzed in this retro-spective study. Demographic features, relevant liver tests, prophylactic treatment type, duration of treatment, transaminase levels and HBV serol-ogy and clinical conditions were recorded from all patients who received prophylactic treatment.RESULTS: Eleven reactivation occurred in all groups. The mean age of patients who developed reactivation was statistically significantly lower (p=0.049). Three (27.3%) of the patients were male and 8 (72.7%) were female (p=0.66). Eight (36.36%) of 22 HB surface antigen (HBsAg) pos-itive patients developed reactivation, 3 (155%) of 155 HBsAg negative patients developed reactiva-tion. HBsAg positivity was determined as a risk factor for reactivation (p<0.001). There was no significant difference neither in reactivation, nor in the type of antiviral treatment (p=0.2) accord-ing to anti-HBs serology (p=0.366).CONCLUSIONS: As a result, early age, base-line HBsAg positivity, moderate risk group, base-line HBV DNA positivity were associated with re-activation. Gender, immunosuppressive therapy type, preemptive antiviral therapy type, and an-ti-HBs titers were not associated with reactivation.