Tuberculosis and hepatitis b serology before anti-tnf treatmentevaluation of scan rate

Introduction: In the latest guidelines and consensus reports, anti-TNF areas associated with rheumatologic and inflammatory bowel disease show pre-Hepatitis B virus (HBV) and latent tuberculosis serology before screening, and the rate of reactivation. Materials and Methods: The records of 291 patients who received anti-TNF treatment in Rheumatology and Gastroenterology Departments of Inonu University Faculty of Medicine were retrospectively reviewed. Results: Before anti-TNF treatment, 217 (74.6%) of 291 patients were screened for HBV. In 65 (22%) of these patients, only HBsAg was studied before anti-TNF treatment, whereas in 152 (52%) HBsAg and anti-HBc were screened together. Serological status of HBV was not known in 74 (25.4%) patients. HBsAg positive, 32 HBsAg negative, anti-HBs and anti-HBc IgG positive, 9 isolated anti-HBc IgG positive, 108 HBsAg negative, anti-HBc IgG negative, Only 64 patients were HBsAg negative and 1 patient was positive for HBsAg. The files of the patients were retrospectively reviewed and no reactivation developed in the follow-up of any HBV screened patient. Anti-TNF treatment was performed before the PPD of all cases and PPD examinations of the patients were 128 (44%) patients between 0-5mm, 119 (40.9%) patients between 5 and 10 mm, 44 patients over 10 mm (15.1%). PPD examinations were performed in 33 of 128 patients between 0-5 mm, 7 of 119 patients between 5 and 10 mm, 3 of 44 patients above 10 mm, IGST negative in 38 (13%), 5 (1.7%) patients were positive. PPD 5 mm or higher or IGST positive patients received INH prophylaxis treatment. Two patients (0.68%) were diagnosed with tuberculosis at the 13th and 14th months after the initiation of anti-TNF treatment. Conclusion: HBV serology ideal screening rates were found to be low in patients receiving anti-TNF treatment. In the same patient group, latent tuberculosis screening rates are within the ideal limits when compared with the literature. No prophylactic antiviral treatment was given to 2 of HBsAg positive and 41 HBsAg negative and anti-HBc IgG positive patients before anti-TNF, and HBV reactivation was not seen in these patients. HBV reactivation risk group before anti-TNF; In HBsAg positive patients, moderate and HBsAg negative and anti-HBc IgG positive patients are in very low risk group and the results of our study are consistent with the literature. In our study, no finding was found in terms of LTBE risk difference between individuals who did not use anti-TNF agents and those who used anti-TNF agents due to lack of control group. Key words: Anti-TNF, Hepatitis B Reactivation, Latent Tuberculosis İnfection, İmmunosuppressive Therapy.