OCRELİZUMAB KULLANAN MULTİPL SKLEROZ HASTALARINDA HEPATİT B VİRÜSÜ SEROLOJİK DURUMU

Yılmaz İnanç, Selçuk Nazi̇k
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Abstract

IN PATIENTS WITH MULTIPLE SCLEROSIS USING OCRELIZUMAB SEROLOGICAL STATUS OF HEPATITIS B VIRUS Abstract 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 end methods Our study is a single-center, retrospective, 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.
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在多发性硬化症患者中使用OCRELIZUMAB乙型肝炎病毒的血清学状态摘要目的B细胞耗竭治疗与病毒感染的潜在风险有关。乙型肝炎病毒(HBV)感染是最常见的慢性病毒感染,据估计,世界上30%的人口有当前或过去感染的血清学证据材料终点方法我们的研究是一项单中心、回顾性、横断面研究。我们回顾性回顾了接受ocrelizumab治疗的多发性硬化症患者的临床记录。患者的人口统计学和临床特征,扩展残疾状态量表(EDSS),ocrelizumab治疗MS前的用药史;记录ocrelizumab的平均摄入次数、吸烟状况、丙型肝炎病毒、HIV血清学状况、HBV血清学状况和HBV治疗状况。结果本研究包括64例接受ocrelizumab治疗的MS患者。平均年龄41.6±9.8岁(最小-最大:21-62岁)。75%为女性(48例),25%为男性(16例)。所有病例的HIV和丙型肝炎病毒血清学检测均为阴性。HBsAg阳性率为1.6%(n:1),抗-HBcIgG阳性率为12.5%(n:8)。开始接受乙型肝炎治疗的患者人数为12.5%(n:8),2名患者开始接受替诺福韦二酯治疗(25%),5名患者开始使用恩替卡韦治疗(62.5%),1名患者开始服用替诺福韦·阿拉芬酰胺治疗(12.5)。患者服用ocrelizumab的平均持续时间为28.5±13.1个月(最短:6-46个月)。结论总之,所有患者在开始ocrelizumab治疗前都应进行HBV筛查。应同时使用HBsAg和抗-HBcIg G检测。抗-HBcIg G的单独存在可能导致HBV再激活。因此,抗-HBcIg G应在免疫抑制治疗前进行筛查。
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