P-120 NATIONAL SURVEY ON CURRENT PRACTICES TO PREVENT HBV REACTIVATION DURING IMMUNOSUPPRESSION

Abstract

Introduction: Reactivation of hepatitis B virus (HBVr) is a problem still neglected worldwide. Objective: To assess knowledge of physicians regarding HBVr during immunosuppression including use of immunobiologics (IS/IB). Methods: Between August and October 2020, a national survey regarding current practices in HBVr prevention was sent to members of the Brazilian Societies of Hepatology, Gastroenterology, Hematology, Rheumatology, Oncology and Transplantation using a web-based approach. Results: 510 physicians answered the survey, mainly gastroenterologists (35%) and rheumatologists (31%). The majority had less than 20 years of clinical practice (62%). 91% reported to routinely request serology for HBV before IS/IB. To 90% of the interviewed doctors, in their clinical practice, serology is missing in less than 25% of their patients already using IS/IB. The most common serology panel requested (75%) is HBsAg, Anti-HBc and Anti-HBs. 76% recommend strategies to prevent HBVr for either HBsAg and/or anti-HBc-positive patients, however, 16% only prescribe to HBsAg-positive. 85% have an specialist on HBVr available for referring patients, but 30% start prevention strategies without the need for specialized evaluation. In this case, the preferred treatment options are entecavir (18%), tenofovir (17%) and lamivudine (6%). 88% reported good adherence of their patients to HBVr prevention strategy. Only 27% referred to maintain prevention strategy for at least 6 months after IS/IB interruption. Finally, 73% of the participants never experienced HBVr on their practice and 42% participated in educational activities about HBVr in the last 2 years. Conclusions: Compared to previous literature, Brazilian physicians seems to have a better compliance to international guidelines toward HBVr prevention. With the exception of duration of HBVr prophylaxis, medical knowledge on this field can be regarded as above average.