Risk of Hepatitis B Virus (HBV) Reactivation in Patients with Immune-Mediated Inflammatory Diseases Receiving Biologics: Focus on the Timing of Biologics after Anti-HBV Treatment
Soo Min Ahn,
Jonggi Choi,
Byong Duk Ye,
Suk-Kyun Yang,
Ji Seon Oh,
Yong‑Gil Kim,
Chang-Keun Lee,
Bin Yoo,
Sang Hyoung Park,
Seokchan Hong
Affiliations
Soo Min Ahn
Department of Rheumatologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Jonggi Choi
Department of Gastroenterologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Byong Duk Ye
Department of Gastroenterologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Suk-Kyun Yang
Department of Gastroenterologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Ji Seon Oh
Department of Information Medicine, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Yong‑Gil Kim
Department of Rheumatologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Chang-Keun Lee
Department of Rheumatologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Bin Yoo
Department of Rheumatologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Sang Hyoung Park
Department of Gastroenterologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Seokchan Hong
Department of Rheumatologye, Big Data Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Background/Aims: Anti-hepatitis B virus (HBV) therapy is required for patients with HBV infection receiving biologics because of the high risk of HBV reactivation. However, it is unclear when to start biologics after anti-HBV treatment. We investigated the risk of HBV reactivation according to the timing of biologics initiation after anti-HBV treatment in immune-mediated inflammatory disease (IMID) patients with HBV infection. Methods: We retrospectively evaluated the incidence of HBV reactivation in IMID patients who received biologics between July 2005 and April 2020. The patients were divided into two groups (within 1-week and after 1-week) according to the timing of biologics initiation after anti-HBV treatment. The cumulative probabilities and factors associated with HBV reactivation were evaluated. Results: A total of 60 hepatitis B surface antigen-positive patients with IMID received biologics (within 1-week group, n=23 [38%]; after 1-week group, n=37 [62%]). During a median follow-up of 34 months (interquartile range, 20 to 74 months), three patients (5%) developed HBV reactivation. In univariate analysis, the timing of biologics after anti-HBV treatment was not significantly associated with the risk of HBV reactivation (hazard ratio, 0.657; 95% confidence interval, 0.059 to 7.327; p=0.733). The cumulative probabilities of HBV reactivation did not significantly differ according to the timing of biologics (p=0.731). Conclusions: The risk of HBV reactivation was not significantly associated with the timing of biologics administration after anti-HBV treatment. Thus, biologics may be initiated early in patients with IMID undergoing treatment for HBV.