Tedavide biyolojik ajanlar kullanan hekimlerin hepatit B virüs reaktivasyonu konusundaki farkındalıkları

Abstract

Objective: As long as immunosuppressive treatments are widely used, careful monitoring of HBVr is essential. We aimed to measure the awareness of Turkish physicians of certain specialties about the risk of hepatitis B virus reactivation (HBVr), HBV screening methods, prophylactic treatment practices and personal experiences in treating patients with biological agents. Methods: An electronic questionnaire link containing 21 questions about demographics and their applications to HBVr was sent to participants working in the various specialties across the country. Results: 227 participants took our survey (Female: 52.4%, n:119, Male: 47.6%, n:108), and consisted of 70 Hematologists, 65 Rheumatologists, 38 Gastroenterologists, 33 Oncologists, and 21 Dermatologists. We obtained extremely different results. It was found that all specialties are aware that the use of biological agents can cause HBVr (97.8%, n:222/227). Biological agents were used in 96% of the participants and HBVr was detected in 53.7% (Hematologist: 74.3%, Rheumatologist: 53.8%, Oncologist: 45.5%, Gastroenterologist: 44.7%, Dermatologist: 14.3%, p< 0.001). The general opinion was that, screening tests should be used (Gastroenterologist: 47.4%, p< 0.001) and 55.1% awared of how to monitor HBVr (Gastroenterologist: 65.8%, p = 0.06). The duration of antiviral prophylaxis was answered correctly in 70.4% (Hematologist: 82.6%, p = 0.01), the parameters of screening tests in 95.2% (Gastroenterologist: 97.4%, p = 0.52) and the highest risk of reactivation in 93% (Rheumatologist: 96.9%, p = 0.15) and the agent with the highest risk of reactivation in 82.8% of participants (Hematologist: 94.3%, p< 0.001). Conclusion: The opinions of different the clinical disciplines vary according to the profile of patients. Gastroenterologists' perspective on HBVr follow-up and treatment differs markedly from that of other clinical disciplines. However, to create general awareness and manage HBVr, guidelines for specific patient groups are definitely needed.