Impact of tumor necrosis factor alpha antagonist treatment on antibody titer of hepatitis B surface antigen

Authors

DOI:

https://doi.org/10.28982/josam.777871

Keywords:

Tumor necrosis factor antagonist, Hepatitis B surface antigen antibody, Autoimmune diseases

Abstract

Aim: Tumor necrosis factor alpha antagonists (anti-TNF-α) have recently been used successfully in various diseases. On the other hand, due to their potential immunogenic effects, they cause hepatitis B virus (HBV) reactivation. The objective of this study is to examine the change in the levels of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) in patients with negative HBsAg who were administered different anti-TNF-α drugs as well as the factors that influence this change. Methods: This research was designed as a retrospective cohort study. Patients with autoimmune diseases who were followed up at General Internal Medicine outpatient clinics between 2012 and 2019, screened for hepatitis B virus (HBV) infection prior to treatment, checked for serological markers (HBsAg, anti-HBs, hepatitis B core antigen antibody (anti-HBc)), and treated with anti-TNF for at least a year were included. The inclusion criteria were as follows: Patients with negative HBsAg and whose liver function tests were within normal limits, and the exclusion criteria included patients with positive HBsAg and whose liver function tests were above the normal upper limit. Results: A total of 221 adult patients who were treated with anti-TNF-α were included in the study. The pretreatment anti-HBs levels of the patients were significantly higher than the posttreatment levels (P<0.001). Of the 211 patients with positive pretreatment anti-HBs levels, 17 patients had posttreatment anti-HBs levels below 10 IU/L. The anti-HBs levels of five patients with positive anti-HBc dropped below 10 IU/L. Conclusions: The anti-HBs levels of the patients who were administered anti-TNF-α agent decreased significantly, whereas there was no reactivation of HBV or de novo HBV infection in HBsAg-negative patients. It was observed in a small group of patients (8.0%) that the levels of anti-HBs decreased to a risky level.

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Published

2020-08-01

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Research Article

How to Cite

1.
Yalçın Kehribar D, Okuyucu M, Özgen M, Ketenci YB, Ayyıldız T, Yıldırım B. Impact of tumor necrosis factor alpha antagonist treatment on antibody titer of hepatitis B surface antigen. J Surg Med [Internet]. 2020 Aug. 1 [cited 2022 Jun. 30];4(8):678-81. Available from: https://jsurgmed.com/article/view/777871