Prevalence and factors related to hepatitis B and C in inflammatory bowel disease patients in Spain: a nationwide, multicenter study

December 29, 2008

Am J Gastroenterol. 2009 Jan;104(1):57-63.

Prevalence and factors related to hepatitis B and C in inflammatory bowel

disease patients in Spain: a nationwide, multicenter study.

Loras C, Saro C, -Huix F, Mínguez M, Merino O, Gisbert JP, Barrio J,

Bernal A, Gutiérrez A, Piqueras M, Calvet X, Andreu M, Abad A, rd D, Bujanda

L, Panés J, M, Fernández-Bañares F, Viver JM, Esteve M.

1Department of Gastroenterology, Hospital Mútua de Terrassa, Fundació per la

Recerca Mútua de Terrassa, Catalonia, Spain.

OBJECTIVES:Limited information suggests the existence of a high prevalence of

hepatitis B (HBV) and C virus (HCV) infection in infl ammatory bowel disease

(IBD). This knowledge is relevant because the viruses may reactivate under

immunosuppressive therapy. The objectives of this study are to assess the

prevalence of HBV and HCV infection in IBD, in a nationwide study, and to

evaluate associated risk factors.METHODS:This cross-sectional multicenter study

included 2,076 IBD patients, consecutively recruited in 17 Spanish hospitals.

Factors related to IBD (severity, invasive procedures, etc.) and to infection

(transfusions, drug abuse, etc.) were registered. Independent risk factors for

viral infection were evaluated using logistic regression

analysis.RESULTS:Present and/or past HBV and HCV infection was found in 9.7% of

patients of both ulcerative colitis (UC) and Crohn's disease (CD) (UC: HBsAg

0.8%, anti-HBc 8%, anti-HCV 1.3%; CD: HBsAg 0.6%, anti-HBc 7.1%, anti-HCV 2.3

%). Effective vaccination (anti-HBs, without anti-HBc) was present in 12% of

patients. In multivariate analysis, age (odds ratio (OR) 1.04; 95% confidence

interval (CI) 1.02-1.06; P=0.000), family history of hepatitis (OR 2.48; 95% CI

1.3-4.74; P=0.006) and moderate-to-severe IBD disease (OR 2.5; 95% CI 1.02-6.15;

P=0.046) were significantly related to HBV, whereas transfusions (OR 2.66; 95%

CI 1.2-5.87; P=0.015) and antibiotic use (OR 2.66; 95% CI 1.1-6.3; P=0.03) were

significantly related to HCV. The significance for transfusions was lost if they

were administered after 1991, when HCV markers became mandatory in blood

banks.CONCLUSIONS:Prevalence of HBV and HCV infection in IBD is similar to that

of the general population of reference and lower than that in previously

published series. This fact, in addition to the lack of association with

invasive procedures, suggests the existence of adequate preventive measures in

centers attending to these patients. The low percentage of effective vaccination

makes it mandatory to intensify B virus vaccination in IBD.Am J Gastroenterol

2009; 104:57-63; doi:10.1038/ajg.2008.4.

Recommended Posts