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News

Prevention of hepatitis infections in patients with inflammatory bowel disease

The latest issue of Alimentary Pharmacology & Therapeutics investigates the prevention and management of hepatitis B and C infections in patients with inflammatory bowel disease.

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Viral hepatitis is a very common infection.

The prevalence of both hepatitis B virus and hepatitis C virus infection in IBD patients is now similar to that of the general population.

All IBD patients should be screened for HBV markers at diagnosis.

Dr Gisbert and colleagues from Spain reviewed the prevention and management of hepatitis B virus and hepatitis C virus infection in inflammatory bowel disease (IBD).

The team performed bibliographical searches in MEDLINE up to 2010.
Peginterferon for hepatitis C virus infection is as effective and safe
Alimentary Pharmacology & Therapeutics

The research team found that liver dysfunction in IBD patients treated with immunosuppressants is more frequent and severe in hepatitis B than in hepatitis C carriers, and is associated with combined immunosuppression.

In patients receiving anti-TNF drugs, hepatitis B virus reactivation is common unless anti-viral prophylaxis is administered.

Hepatitis B surface antigen-positive patients should receive anti-viral prophylaxis before starting immunosuppressants.

The research team found that, as interferon might worsen underlying IBD, nucleoside/nucleotide analogues are preferred for anti-viral prophylaxis in patients with hepatitis B.

IBD patients should be vaccinated against hepatitis B virus at diagnosis.

The researchers noted that the response rate to hepatitis B virus vaccination is low, mainly in those receiving anti-tumor necrosis factor therapy.

The serological response to hepatitis B virus vaccine should be confirmed, and patients with an inadequate response should receive a second full series of vaccine.

Peginterferon for hepatitis C virus infection is as effective and safe as in non-IBD patients.

Dr Gisbert's team concudes, "The present manuscript poses a series of questions on the prevention and management of HBV/HCV infection in IBD, and attempts to answer them using scientific evidence in order to provide practical conclusions for the clinician."

Aliment Pharmacol Ther 2011; 33: 619–633
18 February 2011

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