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Screening for preventable infections in IBD patients

A. Atanassova, I. Kotsev

Abstract

With increasing use of immunomodulators and biologics in IBD patients, there is focus on prevention of infections. ECCO consensus guidelines recommend screening to reduce the risk of infections. Consecutive patients who had screening tests prior to immunomodulatory and/or biologic therapy were included. Data collected on serologic status of hepatitis B, varicella zoster, EBV IgM and IgG. Evidence of previously unknown hepatitis B, hepatitis C or HIV infection, non-immune status to varicella zoster, and serology indicative of no prior EBV infection were considered significant results. Some 42 patients were included (22 Crohn`s disease and 20 ulcerative colitis). Mean age was 40 years (range 21-59 years). One of the patients had evidence of active hepatitis B (HBsAg (+), HBeAg(-), anti-HBe att (+), antiHDV(+)- HBV+HDV, HBVDNA- 1989 IU/mL, HDV-RNA- twice no detectable). This patient began therapy with Lamivudine. After 6 month of therapy, HBV-DNA was 2 IU/mL. Three patients had anti-HBc-total att (+), anti HBs att (+). None of the patients had evidence of active hepatitis C or HIV infection. EBV serology was available in 12 patients and none had EBV IgM. All were positive for EBV IgG indicating past infection. In conclusion, screening in IBD patients prior to initiation of immunomodulatory and/or anti-TNF therapy may pick-up potentially significant number of patients who are at risk of preventable illnesses.




DOI: http://dx.doi.org/10.14748/ssm.v45i0.909

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About The Authors

A. Atanassova
St. Marina University Hospital of Varna
Bulgaria

Clinic of Gastroenterology

I. Kotsev
St. Marina University Hospital of Varna
Bulgaria

Clinic of Gastroenterology

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