Sa1768 A MAJORITY OF YOUNG PATIENTS WITH INFLAMMATORY BOWEL DISEASE HAVE SUSTAINED IMMUNITY TO HEPATITIS B

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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P803 Non-immunity against hepatitis B virus in patients with newly diagnosed inflammatory bowel disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx180.930 ◽

2018 ◽

Vol 12 (supplement_1) ◽

pp. S518-S518

Author(s):

H S Lee ◽

S J Yeo ◽

E S Kim ◽

B I Jang ◽

Y J Lee ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Bowel Disease ◽

Newly Diagnosed ◽

B Virus ◽

Inflammatory Bowel

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Maintaining Hepatitis B Protection in Immunocompromised Pediatric Rheumatology and Inflammatory Bowel Disease Patients

The Journal of Rheumatology ◽

10.3899/jrheum.200283 ◽

2020 ◽

pp. jrheum.200283

Author(s):

Najla Aljaberi ◽

Enas Ghulam ◽

Emily A. Smitherman ◽

Leslie Favier ◽

Dana M.H. Dykes ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Hepatitis B ◽

Bowel Disease ◽

Immunocompromised Patients ◽

Duration Of Treatment ◽

Hbv Vaccine ◽

Booster Vaccine ◽

Significant Difference ◽

Inflammatory Bowel ◽

Hbv Screening

Objective Hepatitis B virus (HBV) infection remains a significant public health challenge, particularly for immunocompromised patients. Our aim was to evaluate the serologic immunity in immunocompromised rheumatology and inflammatory bowel disease (IBD) patients, assess factors for serologic non-immunity and evaluate their response to one HBV booster dose. Methods Immunocompromised rheumatology and IBD patients with completed HBV screening were identified. A chart review was performed to collect demographics, clinical information, baseline HBV serology results, and serologic response to booster vaccination. Serologic nonimmunity was defined as a negative/indeterminate hepatitis B surface antibody (anti-HBs) level. Results Among 580 patients, 71% were non-immune. The highest portion of non-immune patients were 11-18 years old (p 0.004). There was no significant difference between immune and non-immune patients with regards to diagnosis (p 0.342), age at diagnosis (p 0.639), duration of treatment (p 0.069) or type of medications (p 0.080). Sixty-two percent of those who received a booster vaccine were re-screened, and most (68%) seroconverted. In those 18 years or older, only half seroconverted. Conclusion Results of this study support the benefit of HBV screening in immunosuppressed patients. Beginning at age 11 years most patients lacked serologic immunity to HBV. Seroconversion for most patients 11-18 years occurred after one booster vaccine. Thus, for immunocompromised patients without recent HBV serologic data, obtaining the HBV serology beginning at age 11 years might be considered. Those 18 years and older were least likely to seroconvert after one booster, indicating that they may benefit from receiving the three-dose HBV vaccine series.

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Frequency of Hepatobiliary Manifestations and Concomitant Liver Disease in Inflammatory Bowel Disease Patients

BioMed Research International ◽

10.1155/2019/7604939 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Juliana Silva ◽

Beatriz S. Brito ◽

Isaac Neri de N. Silva ◽

Viviane G. Nóbrega ◽

Maria Carolina S. M. da Silva ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Liver Disease ◽

Hepatitis B ◽

Alcoholic Liver Disease ◽

Bowel Disease ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Reference Center ◽

Inflammatory Bowel ◽

Alcoholic Fatty Liver Disease

Background. In inflammatory bowel disease (IBD) patients there are reports of the occurrence of hepatobiliary manifestations, so the aim of this study was to evaluate the hepatobiliary manifestations in patients with Crohn’s disease (CD) and ulcerative colitis (UC) from an IBD reference center. Methods. Cross-sectional study in an IBD reference center, with interviews and review of medical charts, between July 2015 and August 2016. A questionnaire addressing epidemiological and clinical characteristics was used. Results. We interviewed 306 patients, and the majority had UC (53.9%) and were female (61.8%). Hepatobiliary manifestations were observed in 60 (19.6%) patients with IBD. In the greater part of the patients (56.7%) hepatobiliary disorders were detected after the diagnosis of IBD. In UC (18.2%) patients, the hepatobiliary disorders identified were 11 (6.7%) non-alcoholic fatty liver disease, 9 (5.5%) cholelithiasis, 6 (3.6%) primary sclerosing cholangitis (PSC), 3 (1.8%) hepatotoxicity associated with azathioprine, 1 (0.6%) hepatitis B, and 1 (0.6%) hepatic fibrosis. In CD (21.3%) patients, 11 (7.8%) had cholelithiasis, 11 (7.8%) non-alcoholic fatty liver disease, 4 (2.8%) PSC, 3 (2.1%) hepatotoxicity, 1 (0.7%) hepatitis B, (0.7%) hepatitis C, 1 (0.7%) alcoholic liver disease, and 1 (0.7%) autoimmune hepatitis (AIH). There was one case of PSC/AIH overlap syndrome. Conclusion. The frequency of hepatobiliary disorders was similar in both forms of IBD in patients evaluated. The most common nonspecific hepatobiliary manifestations in IBD patients were non-alcoholic liver disease and cholelithiasis. The most common specific hepatobiliary disorder was PSC in patients with extensive UC or ileocolonic CD involvement; this was seen more frequently in male patients.

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Work Productivity Loss in Inflammatory Bowel Disease Patients in Turkey

Gastroenterology Research and Practice ◽

10.1155/2020/6979720 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Firdevs Topal ◽

Hakan Camyar ◽

Elif Saritas Yuksel ◽

Suleyman Gunay ◽

Fatih Topal ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Online Survey ◽

Productivity Loss ◽

Young Patients ◽

Significant Difference ◽

Inflammatory Bowel ◽

The Impact

Background. Beyond the medical treatment in inflammatory bowel disease (IBD), there are other issues which influence the quality of life adversely. The aim of this study was to determine the impact of the IBD patients’ illness on working and education life. Method. The participants were invited to participate in the online survey from the Turkish Crohn’s and Ulcerative Colitis Patient Association network. The data was analysed and then discussed to improve the health-related quality of working and education life. Results. One hundred and fifteen patients had ulcerative colitis (UC) (57.2%), and 86 had Crohn’s disease (CD) (42.8%). There was a statistically significant difference in UC between retirement age group 1 (<40 age) and groups 2 (40-49 ages) and 4 (60-65 ages) (p<0.05). There was the same significant difference in CD. Even though the data did not have significant statistical difference, there was clustering around negative perceptions the patients have about their working and education lives. Conclusion. Our survey revealed a very strong causative relationship between work and IBD involving problems before, during, and at the end of employment. Young patients lower their career expectations, and that announces a clear need to support them and improve career guidance.

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Hepatitis B reactivation: reducing the risk in patients with inflammatory bowel disease

Gut ◽

10.1136/gutjnl-2019-319480 ◽

2020 ◽

Vol 69 (11) ◽

pp. 2053-2054

Author(s):

Grace Elizabeth Dolman ◽

Patrick T F Kennedy

Keyword(s):

Inflammatory Bowel Disease ◽

Hepatitis B ◽

Bowel Disease ◽

Hepatitis B Reactivation ◽

Inflammatory Bowel

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Cost-effectiveness of an Adjuvanted Hepatitis B Vaccine (HEPLISAV-B™) inPatients with Inflammatory Bowel Disease

Crohn's & Colitis 360 ◽

10.1093/crocol/otaa090 ◽

2020 ◽

Author(s):

Juan E Corral ◽

Joshua Y Kwon ◽

Freddy Caldera ◽

Surakit Pungpapong ◽

Aaron C Spaulding ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Chronic Hepatitis ◽

Cost Effectiveness ◽

Hepatitis B ◽

Acute Hepatitis ◽

Bowel Disease ◽

Sensitivity Analyses ◽

Progression Rate ◽

Old Patients ◽

Inflammatory Bowel

Abstract Background Compare the cost-effectiveness of two recombinant hepatitis B vaccines (HBV) in patients with inflammatory bowel disease (IBD). Methods Markov models were developed for two IBD cohorts: A) 40-year-old patients prior to starting IBD treatment and B) 40-year-old patients already receiving therapy. Cohort A received full vaccination series, cohort B had primary vaccine failure and received a vaccine booster. Two vaccines were compared: adjuvanted HEPLISAV-B™ and nonadjuvanted Engerix-B®. Clinical probabilities of acute hepatitis, chronic hepatitis, cirrhosis, fulminant hepatic failure and death, treatment costs and effectiveness estimates were obtained from published literature. A lifetime analysis and a U.S. payer perspective were used. Probabilistic sensitivity analyses were performed for different hypothetical scenarios. Results Analysis of cohort A showed moderate cost-effectiveness of HEPLISAV-B™ ($88,114 per quality adjusted life-year [QALY]). Analysis of cohort B showed increased cost effectiveness ($35,563 per QALY). Changing Engerix-B® to HEPLISAV-B™ in a hypothetical group of 100,000 patients prevented 6 and 30 cases of acute hepatitis; and 4 and 5 cases of chronic hepatitis annually for cohort A and B respectively. It also prevented 1 and 2 cases of cirrhosis, and 1 and 2 deaths over 20 years for each cohort. Cost-effectiveness was determined by vaccination costs, patient age and progression rate from chronic hepatitis to cirrhosis. Conclusions HEPLISAV-B™ is cost-effective over Engerix-B® in patients receiving immunosuppressive therapy for IBD. Benefits increase with population aging and lower costs of vaccines. We advocate measuring protective level of HBV antibodies in patients with IBD and favor adjuvanted vaccines when vaccination is needed.

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