Risk of HBV Reactivation During Immunosuppressive Therapy in Psoriasis: A Retrospective Analysis
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objectives: This study aimed to evaluate the risk of hepatitis B virus (HBV) reactivation in patients with a history of resolved HBV infection or isolated anti-HB core immunoglobulin G positivity who received systemic immunosuppressive therapy for psoriasis. Materials and Methods:A retrospective analysis was conducted on patients ≥18 years old with psoriasis who received systemic immunosuppressive therapy (≥3 months), including methotrexate (MTX), apremilast, cyclosporine, and various biologic agents [tumor necrosis factor-alpha, interleukin (IL)-17, IL-23, IL-12/23 inhibitors] between January 2018 and March 2025.Patients with baseline HBV-DNA positivity, human immunodeficiency virus/ hepatitis C virus co-infection, or incomplete data were excluded.HBV reactivation was defined as either HB surface antigen (HBsAg) seroconversion or detectable HBV-DNA.Patients were classified into three risk groups based on serological status and immunosuppressive regimen.Anti-HBs levels were categorized (<10 IU/L, 10-99 IU/L, and ≥100 IU/L), and risk factors were analyzed using Fisher's exact test and logistic regression.Results: Among 1200 patients screened, 138 eligible individuals were included (63.0% male; mean age 56.9±11.8years).Seven patients (5.0%) experienced HBV reactivation during immunosuppressive therapy, with no cases of acute hepatitis.Reactivation occurred significantly more often in HBsAg-positive and anti-HBs-negative individuals (p=0.008 and p=0.018, respectively).No reactivation was observed in patients with anti-HBs ≥10 IU/L (p<0.001).Logistic regression showed a trend toward higher reactivation risk with HBsAg positivity (odds ratio: ÖZ Amaç: Bu çalışmada, geçirilmiş hepatit B virüsü (HBV) veya izole HB çekirdek antijenine karşı gelişmiş immünoglobulin G antikor pozitifliği olan ve sedef hastalığı nedeniyle sistemik immünosüpresif tedavi alan hastalarda HBV reaktivasyon riski değerlendirildi.Gereç ve Yöntemler: Ocak 2018-Mart 2025 tarihleri arasında, 18 yaş ve üzerindeki psoriazis hastaları retrospektif olarak incelendi.En az üç aydır sistemik immünosüpresif tedavi metotreksat (MTX), apremilast, siklosporin veya biyolojik ajanlar [tümör nekroz faktörü (TNF)-alfa, interlökin (IL)-17, IL-23, IL-12/23 inhibitörü] alan hastalar dahil edildi.Başlangıçta HBV-DNA pozitif olanlar, insan bağışıklık yetmezlik virüsü/hepatit C virüsü ko-enfeksiyonu bulunanlar ve eksik kayıtlı hastalar çalışma dışı bırakıldı.HBV reaktivasyonu, hepatit B yüzey antijeni (HBsAg) serokonversiyonu veya ölçülebilir düzeyde HBV-DNA tespiti olarak tanımlandı.Hastalar serolojik profilleri ve tedavi rejimlerine göre üç risk grubuna ayrıldı.Anti-HBs düzeyleri (<10 IU/L, 10-99 IU/L ve ≥100 IU/L), ayrı ayrı değerlendirildi.Risk faktörleri Fisher'ın kesin testi ve lojistik regresyon analizi ile incelendi.
Source: Viral Hepatitis Journal
Institutions: Sağlık Bilimleri Üniversitesi, Ankara Etlik City Hospital
Language: English
Topic: Hepatitis B Virus Studies
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414205295