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The effects of nucleoside analogue prophylactic treatment on HBV activation in HB c A b+ patients undergoing immunosuppressive therapy
Author(s) -
Liu H.L.,
Zhao Z.,
Yang H.,
Liu F.F.,
Liu Q.,
Luo Q.,
Yuan Q.,
Chen L.M.,
Zeng A.Z.
Publication year - 2013
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12087
Subject(s) - seroconversion , medicine , nucleoside analogue , antibody , gastroenterology , group b , hepatitis b virus , hepatitis b , group a , immunology , nucleoside , virus , biology , biochemistry
Summary We investigated the effects of prophylactic nucleoside analogue treatment on HBV activation in patients with antibodies against core antigen ( HB c A b+) patients undergoing immunosuppressive therapy. Patients (113), who were HB c A b+, with various autoimmune diseases, undergoing immunosuppressive therapy, were divided into two groups. The control group, not treated with antivirals, and the prophylactic group, treated with antiviral drugs. The two groups were evaluated for changes in serum biochemical marker (alanine aminotransferase ALT ), virological marker ( HBV DNA ) and for seroconversion. In the control group, the number of patients with an increase in ALT in patients with isolated HB c A b and HB c A b and antibodies against HB s A g ( HB s A b +) were five (20.0%) and one (2.8%), respectively ( P < 0.05). There were six cases (24.0%) with an increase in HBV DNA in the isolated HB c A b+ subgroup and one case (2.8%) in HB s A b+/ HB c A b+ subgroup ( P < 0.05). In the HB c A b+ only population, six patients (24.0%) in the control group had an increase in HBV DNA compared with none in the antiviral prophylactic group ( P < 0.05). One patient (4.0%) with HB c A b+ in the control group underwent an HB s A g seroconversion when receiving immunosuppressive therapy for 18 months, while none in the antiviral prophylactic group underwent reversion to HB s A g positivity ( P = 0.4949). Under immunosuppressive condition, the risk of HBV activation was much higher in patients with HB c A b than in patients with both HB c A b and antibodies to HB s A b group. Antiviral prophylactic therapy could significantly reduce the risk of HBV reactivation.