ÇÖZÜLMÜŞ HEPATİT B ENFEKSİYONLU VE ROMATİZMAL HASTALIĞI OLAN BİREYLERDE RİTUKSİMAB KULLANIMININ HEPATİT B REAKTİVASYONU ÜZERİNE ETKİSİ: TEK MERKEZLİ BİR ÇALIŞMA

Yıl 2024, Cilt: 12 Sayı: 2, 692 - 701, 20.06.2024

Esra Erdoğan , Mehmet Ali Erdogan , Servet Yolbaş , Muhammed Furkan Keser , Saliha Aydın

https://doi.org/10.33715/inonusaglik.1467613

Öz

Hepatit B enfeksiyonu önemli morbidite ve mortaliteye sahip küresel bir hastalıktır. Bu çalışma, çeşitli romatolojik hastalıkların tedavisinde rituksimab kullanan çözülmüş HBV enfeksiyonlu hastalarda HBV reaktivasyon sıklığını değerlendirmeyi amaçlamaktadır. Romatolojik hastalıkların tedavisi için rituksimab tedavisi alan hastalar serolojik HBV enfeksiyon belirteçleri (HBV DNA, HBsAg, anti-HBc IgG ve anti-HBs) açısından retrospektif olarak tarandı. Çalışmaya HBV DNA negatif, HBsAg negatif ve anti-HBc IgG düzeyleri pozitif olan çözülmüş HBV enfeksiyonlu 25 hasta dahil edildi. Hastalardan 22’si kadın (%88), 3’ü erkek (%12) idi. Hastaların yaş ortalaması 62.56±9.786 idi. 25 hastanın 22’si romatoid artrit hastası, ikisi Sjögren sendromu iken bir hasta sistemik lupus eritamatozus hastasıydı. 15 hastada anti-HBs pozitif iken 10 hastada anti-HBs negatifti. Hastaların tedavi öncesi ortalama HBsAg titresi 0.27±0.102 iken anti-HBs titresi 211.00±317.380 IU/L idi. Çalışmaya dahil edilen hastaların hiçbirinde hepatit B reaktivasyonu gözlenmedi. Bu veriler, romatolojik hastalıkları olan hastaların rituksimab tedavisi altında HBV enfeksiyonunun reaktivasyon riskinin düşük olduğu göstermektedir. Ancak kesin sonuçlara varmak için prospektif, daha fazla hastanın dahil olduğu, çok merkezli çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

Hepatit B virüsü, HBV reaktivasyonu, Rituksimab, Romatolojik hastalıklar

Etik Beyan

Çalışma, Helsinki Bildirgesi ve İyi Klinik Uygulama İlkeleri'ne uygun olarak gerçekleştirildi. İnönü Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan onay alındı (Tarih: 22.01.2021 ve Karar No: 1126).

Destekleyen Kurum

yok

Proje Numarası

Tarih: 22.01.2021 ve Karar No: 1126

Teşekkür

Çalışmaya dahil edilen hastaların takip ve tedavisine dahil olan tüm sağlık çalışanlarına teşekkür ederiz.

Effect of Rituximab Use on Hepatitis B Reactivation in Individuals with Resolved Hepatitis B Infection and Rheumatic Disease: A Single Center Study

Öz

Hepatitis B infection is a global disease with significant morbidity and mortality rates. This study aims to evaluate the frequency of HBV reactivation in patients with resolved HBV infection using rituximab for the treatment of various rheumatological diseases. Patients receiving rituximab therapy for the treatment of rheumatic diseases were retrospectively screened for serological HBV infection markers (HBV DNA, HBsAg, anti-HBc IgG and anti-HBs). Twenty-five patients with resolved HBV infection who were HBV DNA-negative, HBsAg-negative and anti-HBc IgG-positive were included in the study. Twenty-two patients were female (88%) and three were male (12%). The average age of the patients was 62.56±9.786 years. Out of 25 patients, 22 had rheumatoid disease, two had Sjögren's syndrome, and one patient had systemic lupus erythematosus. While anti-HBs was positive in 15 patients, anti-HBs was negative in 10 patients. The mean HBsAg titer of the patients before treatment was 0.27±0.102, while the anti-HBs titer was 211.00±317.380 IU/L. Hepatitis B reactivation was not observed in any of the patients included in the study. Hence, the data suggest that patients with rheumatological diseases have a low risk of reactivation of HBV infection under rituximab treatment. However, prospective, multicenter studies involving more patients are needed to reach definitive conclusions.

Anahtar Kelimeler

Hepatitis B virus, HBV reactivation, Rituximab, Rheumatological diseases.

Proje Numarası

Tarih: 22.01.2021 ve Karar No: 1126

Kaynakça

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