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N814 Improvement in the treatment and management of patients affected by inflammatory bowel disease: hepatitis B and vaccination status

Onidi F.M., Mocci G., Cabras F.

Azienda Ospedaliera Brotzu, Cagliari, Italy

Background

The prevalence of HBV infection in patients with inflammatory bowel disease (IBD) is similar to that found in the general population. However, in patients with IBD several conditions such as malnutrition, surgery and immunosuppressive therapies, particularly anti-TNFα agents, may lead to a recurrence of HBV infection. International guidelines suggest HBV vaccination for all HBV anti-HBcAb seronegative patients already at diagnosis or before starting treatments with immunosuppressant. However, studies have shown that the percentage of vaccination of HBV patients affected by IBD is still low.

The objective is to assess the prevalence of HBV and the rate of HBV vaccination in a population of IBD patients

Methods

Monocenter observational study. Collection of data was carried out in the first trimester of 2016 in the day hospital of Gastroenterology Unit at Brotzu Hospital, for a total amount of 130 patients. Data were collected on a nursing questionnaire which was created for the study.

Results

130 patients were studied. Of these, 57 (44%) were treated with biological agents (adalimumab, golimumab, infliximab). The majority of these patients were women (56%). The percentage of patients with ulcerative colitis (UC) was 72% overall, while in the sub-group of patients treated with anti-TNFa agents those with UC and Crohn's disease (CD) were 48% and 52% respectively. The study has shown a vaccination rate of 60%, reaching 70% in the sub-group of patients receiving biological treatments (36 out of 54).

Conclusion

Vaccination against HBV in patients with IBD is important because of the risk of recurrence of the infection during treatment with immunosuppressive drugs, especially anti-TNFα biologic therapy. These data suggest that more effort is needed to increase vaccination rates among IBD patients, as soon as possible, at least before beginning treatments with immunosuppressants.