Risk of Hepatitis B Virus Reactivation in Patients with Resolved Infection on Therapy with Corticosteroids and Conventional Synthesis Immunosuppressants for Kidney Disease: A Single-Center Analysis of 258 Patients

Turk J Gastroenterol. 2023 Oct;34(10):1035-1040. doi: 10.5152/tjg.2023.22511.

Abstract

Background/aims: The risk of hepatitis B virus reactivation in patients with a previously resolved hepatitis B virus infection on therapy with corticosteroids and conventional synthesis immunosuppressants for kidney disease has not been well described.

Materials and methods: We performed a retrospective study on the risk of hepatitis B virus reactivation in patients with a previously resolved hepatitis B virus infection on therapy with corticosteroids and conventional synthesis immunosuppressants for kidney disease between January 2012 and December 2021 in the Department of Nephrology at Ruijin Hospital.

Results: A total of 258 patients with a previously resolved hepatitis B virus infection [all treated with high-dose corticosteroids, of whom 192 were receiving corticosteroids combined with conventional synthesis immunosuppressant therapy, including cyclophosphamide (155), cyclosporine A (14), mycophenolate mofetil (14), and tacrolimus (9)] were enrolled. During a mean follow-up time of 21.66 months (range 9-70 months), hepatitis B virus reactivation was not observed in these patients.

Conclusions: Among patients with a previously resolved hepatitis B virus infection on therapy with corticosteroids and conventional synthesis immunosuppressants for kidney disease, hepatitis B virus reactivation was not common and severe, suggesting that universal prophylaxis may not be justified or cost-effective in this clinical setting.

MeSH terms

  • Adrenal Cortex Hormones / pharmacology
  • Adrenal Cortex Hormones / therapeutic use
  • Antiviral Agents / therapeutic use
  • Hepatitis B Surface Antigens
  • Hepatitis B virus / physiology
  • Hepatitis B*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Diseases*
  • Retrospective Studies
  • Virus Activation

Substances

  • Immunosuppressive Agents
  • Adrenal Cortex Hormones
  • Hepatitis B Surface Antigens
  • Antiviral Agents

Grants and funding

The authors declared that this study has received no financial support.