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HEPATITIS REACTIVATION IN RHEUMATOLOGICAL PATIENTS AFTER BIOLOGICAL TREATMENT

Dr.Hana S Alahmari, Dr.Bayan H Alaqhatani, Dr. Majed Alsubaie, Dr. Hissah I ALMania, Dr. Hanady M Alhumaidi, Dr. Manal M AL-Qahtani, Dr. Mansour Somaily

Introduction: Both Hepatitis B (HBV) and Hepatitis C (HCV) virus can cause chronic liver disease and hepatocellular carcinoma. Approximately 1 in every 3 individuals worldwide may have been exposed to hepatitis virus. The use of immunosuppressive and biological modifier agents for rheumatoid diseases which may result in reactivations among patients infected with HBV and HCV. Reactivation with its potential consequences is particularly a concern when these people are exposed to immunosuppressive therapies for the management of rheumatologic conditions. Objective: To examine the incidence of reactivation or flare in chronic HBV and HCV patients who are at the same time treated for rheumatological disorder by immunosuppressant. Subjects &Methods: This was a retrospective hospital record-based study. Study subjects include any patients who have follow up appointments in the rheumatology clinic in Aseer Central Hospital, Abha for rheumatological disease and has used immunosupp-ressive medications and labelled to have chronic hepatitis C or B. A structured and pretested proforma was used as study tool. SPSS was used for statistical analysis. Results: 78.8% of the cases having chronic hepatitis &receiving immunosuppressive drugs had HBV. Marked reduction of hepatic profile was noted in cases who received only one ISD as compared to two or three drugs consumption. On studding PCR change before and after receiving immunosuppressive drugs it was clear that 54.6% of the cases had no change. As for albumin, cases on combined therapy recorded 10.9% increase in its initial value compared to no change in the other cases (P>0.05). Conclusions: There was marked reduction of hepatic profile in cases with only one ISD. Cases on combined therapy recorded significant change for albumin. Keywords: Rheumatological disorder; Immunosuppressant drug (ISD), Hepatitis B & C, PCR.

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