P364 Immunization status in IBD patients -a single centre study in Southern Italy
M. Ardesia*1, A. Ferrara1, A. Alibrandi2, W. Fries1
1University of Messina, Department of Clinical and Experimental Medicine, Messina, Italy, 2University of Messina, Department of Economical, Financial, Social, Environmental, Statistical and Territorial Sciences, Messina, Italy
With the use of more potent immunosuppressive agents, the most recent ECCO guidelines have raised the need for a more accurate screening in IBD patients, not only to investigate former infectious disease but also to guide the choice for the therapeutic agent to use. The aim of the present study was to investigate the prevalence of hepatitis B and C, latent tuberculosis, and the immunization status for mononucleosis, varicella, and cytomegalovirus in a cohort of IBD outpatients.
We retrospectively revised the patient's charts from the past 5 years in our outpatient clinic; data on hepatitis B (HBsAg, anti-HBs, anti-HBc) and C (anti-HCV), tuberculosis (TBC; Mantoux skin test or Quantiferon Gold, and plain chest film), mononucleosis (anti-VCA IgG), varicella (anti-VZV IgG), and cytomegalovirus (anti-CMV IgG) were registered together with the following data: gender, disease, duration of disease, IBD therapy prior to testing. Moreover we evaluated potential risk factors for the presence of positive findings like age, disease, duration of disease, previous therapies in order to identify associated risk factors; vaccinated patients against hepatitis B were excluded from analysis.
The charts from 968 IBD patients were reviewed. Data from 270 patients screened for biologic and/or thiopurine therapy were analysed (ulcerative colitis [UC] 119, Crohn's disease [CD] 151; mean age 41 years ± 15, males 152); median disease duration was 48 months (range: 0-360); data on screening positivity are given in table 1 by dividing patients in 2 age groups, less than or equal to 35 years and older than 35 years.
“Table 1 percentages of positive testing for former infections”
There was no difference between UC and CD patients; a significant positive correlation was found between age and anti-HCV positivity (p<0.005), anti-HBc (p<0.03), latent TBC (p<0.004), and anti-CMV positivity (p<0.003).
An age over 35 years significantly increases the probability to test positive for TBC, hepatitis C, and anti CMV; although not significant, an important percentage of younger patients was negative for Ebstein-Barr virus (16%) and for varicella (19%). The latter data may be important for vaccination issues.