P373. Serology of viral infections in patients with inflammatory bowel disease
S. Riestra1, R. de Francisco1, I. Perez1, O. Castano1, L. Blanco1, M. Varela1, L. Rodrigo1, 1Huca, Gastroenterology, Oviedo, Spain
Serological status of IBD patients regarding infection by the hepatitis A (HAV), B (HBV) and C (HCV) virus, human immunodeficiency virus (HIV), Epstein-Barr virus (EBV), varicella-zoster virus (VZV) and cytomegalovirus (CMV) is poorly understood.
In order to determine the frequency of infection with HAV, HBV, HCV, HIV, EBV, CMV and VZV we evaluate, from September 2011 to October 2012, the serologic status of patients with IBD attended at an IBD Unit in Spain; in those cases missing serological studies, these were completed.
787 IBD patients (467 with Crohn's disease [CD], 293 with ulcerative colitis [UC] and 27 with colitis unclassified) were studied; 430 (54.6%) were female, the mean age was 44.3 years and the mean duration of IBD was 117.2 months. At the time of the study 98 patients received no treatment for IBD, 330 received 5ASA, 310 thiopurines, 61 corticosteroids, 143 anti-TNF, 9 others and 92 ≥2 immunosuppressive drugs. At baseline, serological study of HAV, HBV, HCV, HIV, EBV, CMV and VZV had been performed in 30.5%, 83.2%, 83.1%, 42.3%, 45.4%, 54.8% and 57.9%, respectively. The frequency of past infection by HAV was 45.7% (322/704). Regarding HBV, past infection (antiHBcore with or without antiHBs) was found in 4% (31/770), while 0.5% (4/770) were HBsAg carriers; antiHBs ≥10 UI/ml was demonstrated in 18.8% (129/770) subjects. HCV infection was found in 1.4% (11/768), and positive serology for HIV in 0.1% (1/722). Past infection by EBV and VZV were demonstrated in 96.4% (699/725) and 95.2% (696/732) of patients, respectively. Overall, 60.3% (449/745) of patients had been in contact with CMV (62.9%, 171/272 among patients with UC). Of the patients who were receiving any immunosuppressive treatment, 77.5% (335/432) were not immunized against HBV and 95.1% (386/406) had had varicella. Among patients treated with thiopurines, 95.2% (275/289) had markers of past infection by EBV.
In our area, more than 95% of patients with IBD have been infected by EBV and VZV. 63% of patients with UC are at risk for reactivation of CMV. A high percentage of patients are not immunized against HBV. Under immunosuppressive treatment a high percentage of patients with IBD are at risk of reactivation of VZV and HBV acquisition.