Abstract
Patients with chronic inflammatory bowel diseases (IBD) have long been considered at risk for viral hepatitis B. However, recent epidemiological studies have found similar prevalence, or even lower than in the general population. The objective of this work is to determine the prevalence of viral hepatitis B (HVB) during IBD, to determine the risk factors in the service of Hepato-gastroenterology of university hospital Hassan II-Fez, and of evaluate the impact on therapeutic management. PATIENTS AND METHODS: This is a retrospective study, spread over a period of 17 years and a half (January 2001-June 2017). All patients treated for IBD who are tested for Hbs Ag and anti Hbcwere included. The HVB DNA levels were tested in case of positivity of HbsAgor anti Hbc. Results: Over the study period, 755 patients were included. The average age of our patients was 35 years [14 - 87] with a sex-ratio H/F of 0.67. We had 391 cases (51.8%) of Crohn’s disease (CD) and 364 cases (48.2%) of ulcerative colitis (UC). Anti HBctest was positive in 1.98% of cases (N = 15). In these patients, HBsAg was positive in 1.19% of cases (N = 9). The prevalence of HVB was 2.55% in CD (N = 10) versus 1.37% in UC (N = 5). In our work, no history of surgery, digestive endoscopy or transfusion has been shown to be a risk factor for viral transmission. CONCLUSION: The prevalence of HVB in IBD is similar to that of the general population. The safety of blood transfusions and the improvement of asepsis probably explain these results. However, the risk of viral reactivation during HVB, sometimes fatal under immunosuppressive treatment, requires systematic screening.
Highlights
Viral hepatitis B is a real public health problem
The objective of this work is to determine the prevalence of viral hepatitis B (HVB) during inflammatory bowel diseases (IBD), to determine the risk factors in the service of Hepatogastroenterology of university hospital Hassan II-Fez, and of evaluate the impact on therapeutic management
All patients treated for IBD who are tested for Hbs Ag and anti Hbcwere included
Summary
Viral hepatitis B is a real public health problem. Each year, about 10 to 30 million new infections are reported. The indications for immunosuppressive drugs (mainly azathioprine/mercaptopurine and methotrexate) and immunomodulators have continued to increase due to their clinical benefits. Concerns about the safety of prescribing immunosuppressive drugs are becoming more and more important for professionals involved in the management of these patients. Among these concerns is the risk of reactivation of viral hepatitis B. The main objective of this study is to evaluate the prevalence of chronic HVB in patients treated for IBD in the Fez University Hospital, and to determine risk factors involved in the transmission of HBV infection
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