Ocrelizumab Kullanan Multipl Skleroz Hastalarında Hepatit B Virüsü Serolojisi

Yıl 2023, Cilt: 18 Sayı: 3, 51 - 54, 20.11.2023

Yılmaz İnanç , Selçuk Nazik

https://doi.org/10.17517/ksutfd.1158614

Öz

Amaç: B-hücresi tüketen tedaviler, potansiyel viral enfeksiyon riskleri ile ilişkilidir. Hepatit B virüsü (HBV) enfeksiyonu en yaygın kronik viral enfeksiyondur ve dünya nüfusunun tahminen %30'unun mevcut veya geçmiş enfeksiyona ilişkin serolojik kanıtlara sahip olduğu tahmin edilmektedir.
Gereç ve Yöntemler: Çalışmamız tek merkezli, retrospektif, kesitsel bir çalışmadır. ocrelizumab alan Multiple Skleroz (MS) hastalarının klinik kayıtlarını geriye dönük olarak inceledik. Hastaların demografik ve klinik özellikleri, Ortalama Expanded Disability Status Scale (EDSS), MS için ocrelizumab öncesi ilaç geçmişi; ortalama ocrelizumab alma süreleri, sigara kullanım durumu, Hepatit C virüs, HIV serolojik durumları, HBV serolojik durumu, HBV tedavi durumu kaydedildi.
Bulgular: Çalışmaya ocrelizumab ile tedavi edilen 64 MS hastası dahil edildi. Ortalama yaş 41.6±9.8 yıl (min-max: 21-62 yıl) idi. Olguların %75’i kadın (n:48), %25’i erkek (n:16) idi. Olguların tümünde HIV, Hepatit C virüs serolojik testleri negatif idi. HBsAg %1.6 (n:1), Anti HBcIgG %12.5 (n:8) oranında pozitif saptandı. Hepatit B tedavisi başlanan hasta sayısı %12.5 (n:8) olup, 2 hastaya (%25) tenofovir disoproksil, 5 hastaya (%62.5) entekavir, 1 hastaya (12.5) tenofovir alafenamid tedavisi başlanmıştır. Hastaların ortalama ocrelizumab alma süreleri 28.5±13.1 ay (min-max:6-46 ay) olarak saptandı.
Sonuç: Sonuç olarak, ocrelizumab tedavisine başlamadan önce tüm hastalarda HBV taraması yapılmalıdır. Hem HBsAg hem de Anti-HBcIg testleri kullanılmalıdır. Anti-HBcIg G’nin varlığı HBV reaktivasyonunu engellemez, bu nedenle immünosupresif tedaviden önce Anti-HBcIg açısından mutlaka taranmalıdır.

Anahtar Kelimeler

Multipl skleroz, ocrelizumab, hepatit B virüs

Status of Hepatitis B Virus Serological In Patients With Multipl Sclerosis Using Ocrelizumab

Öz

Objective: B-cell depleting treatments are associated with potential risks of viral infections. Hepatitis B virus (HBV) infection is the most common chronic viral infection and it is estimated that 30% of the world population has serological evidence of current or past infection.
Material and Methods: Our study is a single-center, cross-sectional study. We retrospectively reviewed the clinical records of MS patients receiving ocrelizumab. Demographic and clinical characteristics of patients, Expanded Disability Status Scale (EDSS), drug history before ocrelizumab for MS; Mean ocrelizumab intake times, smoking status, hepatitis C virus, HIV serological status, HBV serological status, HBV treatment status were recorded.
Results: The study included 64 MS patients treated with Ocrelizumab. The mean age was 41.6±9.8 years (min-max: 21-62 years). 75% of the cases were female (n:48), 25% were male (n:16). HIV and hepatitis C virus serological tests were negative in all cases. HBsAg was found to be positive in 1.6% (n:1) and Anti-HBcIgG in 12.5% (n:8). The number of patients who were started on hepatitis B treatment was 12.5% (n:8), and tenofovir disoproxil was started in 2 patients (25%), entecavir in 5 patients (62.5%), and tenofovir alafenamide in 1 patient (12.5). The mean duration of taking ocrelizumab for the patients was 28.5±13.1 months (min-max: 6-46 months).
Conclusion: In conclusion, all patients should be screened for HBV before starting ocrelizumab therapy. Both HBsAg and Anti-HBcIg G tests should be used. The isolated presence of Anti-HBcIg G may cause HBV reactivation. Therefore, Anti-HBcIg G should be screened before immunosuppressive therapy

Anahtar Kelimeler

multiple sclerosis, ocrelizumab, hepatitis B virus

Kaynakça

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