Sa1248 Comparison Between Sci-B-Vac™ (Third Generation Vaccine) and Engerix-B Vaccines for Hepatitis B Virus in Patients With Inflammatory Bowel Diseases Treated With Immunosuppressive Medications. Randomized Control Trial

Abstract Background Acute-on-chronic liver failure (ACLF) is characterized by an excessive systemic inflammatory response and organ failure and has high mortality. Bacterial infections (BIs) worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients. The efficacy of third-generation cephalosporins has been challenged in recent years. The aim of this study was to characterize the difference between ACLF patients with and without BIs and to provide a reference for medical intervention. Methods A total of 140 patients with hepatitis B virus-related ACLF (HBV-ACLF) hospitalized at the Department of Infectious Diseases, Huashan Hospital, Fudan University (Shanghai, China) between May 2013 and January 2020 were enrolled. Mann-Whitney U test was used to compare the baseline characteristics of HBV-ACLF patients with and without BIs. Univariate and multivariate analyses were performed to find predictors of BIs. The characteristics of BIs and the role of prophylactic antibiotics were profiled. Results A total of 97 episodes of BIs occurred in patients during the course of HBV-ACLF. Patients with and without BIs differed in clinical characteristics. The incidence of BIs showed a positive correlation with the ACLF grade (P = 0.003) and the clinical course (P = 0.003). The 90-day transplant-free survival of patients with BIs was lower than those without BIs (P < 0.0001). Patients administered prophylactic antibiotics showed a lower incidence of BIs and had a higher transplant-free survival probability than those who did not (P = 0.046). No statistical differences in antibiotic efficacy between third-generation and other antibiotics were observed (P = 0.108). Conclusions BIs affected the clinical course and prognosis of patients with HBV-ACLF. Prophylactic antibiotics were of potential clinical importance in the prevention of BIs and improving the clinical course and prognosis in HBV-ACLF patients. Third-generation cephalosporins were qualified for use in antibiotic prophylaxis.

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Sa1124 A Report on the Prevalence and Reactivation Rate of Hepatitis B Virus in Patients With Inflammatory Bowel Disease in Japan

Gastroenterology ◽

10.1016/s0016-5085(14)60728-9 ◽

2014 ◽

Vol 146 (5) ◽

pp. S-206

Author(s):

Yoko Yokoyama ◽

Mikio Kawai ◽

Koji Kamikozuru ◽

Masaki Iimuro ◽

Nobuyuki Hida ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Bowel Disease ◽

B Virus ◽

Inflammatory Bowel

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Hepatitis B Virus Reactivation Induced by Infliximab Administration in a Patient with Crohn’s Disease

Case Reports in Hepatology ◽

10.1155/2013/461879 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Yuka Miyake ◽

Aki Hasebe ◽

Tetsuya Tanihira ◽

Akiko Shiraishi ◽

Yusuke Imai ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Hepatitis B Virus ◽

Crohn's Disease ◽

Hepatitis B ◽

Bowel Disease ◽

Hbv Dna ◽

Hbv Reactivation ◽

B Virus ◽

Inflammatory Bowel

A 47-year-old man diagnosed with Crohn’s disease was treated with infliximab. He tested negative for hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) but positive for anti-HB core antibody (anti-HBc). He tested positive for hepatitis B virus (HBV-) DNA 3 months after treatment and was administered entecavir. HBV-DNA test showed negative results 1 month later. ALT was persistently within the normal range, and HBV-DNA was persistently negative thereafter despite the continuation of infliximab every 8 weeks. In our hospital, 14 patients with inflammatory bowel disease, who tested negative for HBsAg, were treated with infliximab; 2 of them tested positive for anti-HBs and/or anti-HBc, and HBV reactivation was observed in 1 patient (the present patient). The present case and these findings highlight that careful follow-up is needed in patients with inflammatory bowel disease treated with infliximab who test positive for anti-HBc and/or anti-HBs.

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