Risk of Hepatitis B Virus Reactivation in Patients with Neurological Diseases Receiving Anti-CD20 Therapies

İpek Gungor Dogan; Feyzullah Yadi; Damla Çetinkaya Tezer; Serkan Demir

Makale detayları

Risk of Hepatitis B Virus Reactivation in Patients with Neurological Diseases Receiving Anti-CD20 Therapies

Yazarlar:

İpek Gungor Dogan | Feyzullah Yadi | Damla Çetinkaya Tezer | Serkan Demir

Yayıncı:

Kocaeli University

Ana Başlıklar:

Sinirbilim (Diğer)

Dergi:

Acta Medica Nicomedia Vol.8 Issue 2, pp.121-125

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001353774

pISSN:

2717-8994

Anahtar kelimeler:

Özet:

 ABSTRACT Objective: Anti-CD20 therapies, including ocrelizumab, rituximab, and ofatumumab, are widely used in treating immune-mediated neurological diseases. However, these therapies may increase the risk of hepatitis B virus HBV reactivation, particularly in patients with prior HBV exposure. Despite the recognized preventive measures for managing HBV reactivation, specific data regarding the safety of anti-CD20 therapies in this context remain limited. This retrospective study aims to evaluate the risk of HBV reactivation among patients with neurological disorders treated with anti-CD20 therapies in a single-center cohort from Türkiye. Methods: We reviewed the records of 580 patients who received at least one dose of anti-CD20 therapies between July 2018 and March 2024. HBV serological markers were assessed at baseline and during follow-up. Patients were stratified based on HBV serostatus, and antiviral prophylaxis rates were documented. Serological follow-up data were reviewed for seroconversion. Results: Of the patients, 12.24 showed anti-HBc positivity, with higher rates in the ocrelizumab group 15.57 compared to rituximab 8.08 and none in the ofatumumab group. Among the anti-HBs positive group, the prophylaxis rate was 78, while it was 100 in the anti-HBs negative side. No seroconversion cases were observed, regardless of prophylaxis status. Conclusions: Our findings indicate that anti-CD20 therapies do not pose a detectable risk of HBV reactivation in patients with immune-mediated neurological disorders, even when antiviral prophylaxis is not given to those who are anti-HBs positive. However, further prospective studies with larger cohorts must confirm these results and improve HBV management in this patient population.

 ABSTRACT Objective: Anti-CD20 therapies, including ocrelizumab, rituximab, and ofatumumab, are widely used in treating immune-mediated neurological diseases. However, these therapies may increase the risk of hepatitis B virus HBV reactivation, particularly in patients with prior HBV exposure. Despite the recognized preventive measures for managing HBV reactivation, specific data regarding the safety of anti-CD20 therapies in this context remain limited. This retrospective study aims to evaluate the risk of HBV reactivation among patients with neurological disorders treated with anti-CD20 therapies in a single-center cohort from Türkiye. Methods: We reviewed the records of 580 patients who received at least one dose of anti-CD20 therapies between July 2018 and March 2024. HBV serological markers were assessed at baseline and during follow-up. Patients were stratified based on HBV serostatus, and antiviral prophylaxis rates were documented. Serological follow-up data were reviewed for seroconversion. Results: Of the patients, 12.24 showed anti-HBc positivity, with higher rates in the ocrelizumab group 15.57 compared to rituximab 8.08 and none in the ofatumumab group. Among the anti-HBs positive group, the prophylaxis rate was 78, while it was 100 in the anti-HBs negative side. No seroconversion cases were observed, regardless of prophylaxis status. Conclusions: Our findings indicate that anti-CD20 therapies do not pose a detectable risk of HBV reactivation in patients with immune-mediated neurological disorders, even when antiviral prophylaxis is not given to those who are anti-HBs positive. However, further prospective studies with larger cohorts must confirm these results and improve HBV management in this patient population.

 ABSTRACT Objective: Anti-CD20 therapies, including ocrelizumab, rituximab, and ofatumumab, are widely used in treating immune-mediated neurological diseases. However, these therapies may increase the risk of hepatitis B virus HBV reactivation, particularly in patients with prior HBV exposure. Despite the recognized preventive measures for managing HBV reactivation, specific data regarding the safety of anti-CD20 therapies in this context remain limited. This retrospective study aims to evaluate the risk of HBV reactivation among patients with neurological disorders treated with anti-CD20 therapies in a single-center cohort from Türkiye. Methods: We reviewed the records of 580 patients who received at least one dose of anti-CD20 therapies between July 2018 and March 2024. HBV serological markers were assessed at baseline and during follow-up. Patients were stratified based on HBV serostatus, and antiviral prophylaxis rates were documented. Serological follow-up data were reviewed for seroconversion. Results: Of the patients, 12.24 showed anti-HBc positivity, with higher rates in the ocrelizumab group 15.57 compared to rituximab 8.08 and none in the ofatumumab group. Among the anti-HBs positive group, the prophylaxis rate was 78, while it was 100 in the anti-HBs negative side. No seroconversion cases were observed, regardless of prophylaxis status. Conclusions: Our findings indicate that anti-CD20 therapies do not pose a detectable risk of HBV reactivation in patients with immune-mediated neurological disorders, even when antiviral prophylaxis is not given to those who are anti-HBs positive. However, further prospective studies with larger cohorts must confirm these results and improve HBV management in this patient population.

 ÖZ Amaç: Ocrelizumab, rituksimab ve ofatumumab gibi anti-CD20 tedavileri, immun aracılı nörolojik hastalıkların tedavisinde yaygın olarak kullanılmaktadır. Ancak, bu tedaviler, özellikle daha önce hepatit B virüsü HBV ile karşılaşmış hastalarda HBV reaktivasyonu riskini artırabilir. HBV reaktivasyonunun yönetimi için tanımlanan önleyici tedbirlere rağmen, bu bağlamda anti-CD20 tedavilerinin güvenliği hakkında spesifik veriler sınırlıdır. Bu retrospektif çalışma, Türkiyedeki tek merkezli bir kohortta anti-CD20 tedavisi alan ve nörolojik hastalığı bulunan hastalarda HBV reaktivasyonu riskini değerlendirmeyi amaçlamaktadır. Yöntemler: Temmuz 2018 ile Mart 2024 arasında en az bir doz anti-CD20 tedavisi almış 580 hastanın kayıtları incelenmiştir. HBV serolojik belirteçleri başlangıçta ve takip sırasında değerlendirilmiştir. Hastalar, HBV serostatusuna göre kategorize edilmiş ve antiviral profilaksi oranları kaydedilmiştir. Serolojik takip verileri, serokonversiyon için gözden geçirilmiştir. Bulgular: Hastaların 12,24ü anti-HBc pozitifti; ocrelizumab grubunda 15,57; rituksimab grubunda ise 8,08 oranında pozitiflik gözlemlendi, ofatumumab grubunda ise anti-HBc pozitif hasta bulunmamaktaydı. Anti-HBs pozitif olan grupta profilaksi oranı 78, anti-HBs negatif olan grupta ise 100dü. Profilaksi durumuna bakılmaksızın serokonversiyon vakası gözlemlenmedi. Sonuçlar: Bulgularımız, anti-CD20 tedavilerinin, özellikle anti-HBs pozitif olan hastalarda antiviral profilaksi uygulanmıyor olsa dahi, immun aracılı nörolojik hastalıkları bulunan hastalarda HBV reaktivasyonu riskini tespit edilebilir şekilde arttırmadığını göstermektedir. Ancak, bu sonuçların doğrulanması ve HBV yönetiminin iyileştirilmesi için daha geniş kohortlarla yapılacak prospektif çalışmalara ihtiyaç vardır.

Makale detayları

Risk of Hepatitis B Virus Reactivation in Patients with Neurological Diseases Receiving Anti-CD20 Therapies

Yazarlar:

İpek Gungor Dogan | Feyzullah Yadi | Damla Çetinkaya Tezer | Serkan Demir

Yayıncı:

Kocaeli University

Ana Başlıklar:

Sinirbilim (Diğer)

Dergi:

Acta Medica Nicomedia Vol.8 Issue 2, pp.121-125

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001353774

pISSN:

2717-8994

Anti-CD20 Therapies

HBV Reactivation

Multiple Sclerosis

Ocrelizumab

Antiviral ProphylaxisAnti-CD20 tedavileri

HBV reaktivasyonu

Multiple Skleroz

Okrelizumab

Antiviral Profilaksi

Sayı

Makale detayları

Yazarlar: İpek Gungor Dogan | Feyzullah Yadi | Damla Çetinkaya Tezer | Serkan Demir

Yayıncı: Kocaeli University

Ana Başlıklar: Sinirbilim (Diğer)

Dergi: Acta Medica Nicomedia Vol.8 Issue 2, pp.121-125

Belge Tipi: Makale

Yayın Tarihi: 6/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001353774

pISSN: 2717-8994

Sayı

Yazarlar:

İpek Gungor Dogan | Feyzullah Yadi | Damla Çetinkaya Tezer | Serkan Demir

Yayıncı:

Kocaeli University

Ana Başlıklar:

Sinirbilim (Diğer)

Dergi:

Acta Medica Nicomedia Vol.8 Issue 2, pp.121-125

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001353774

pISSN:

2717-8994