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Gastroenterologists Have Suboptimal Hepatitis B Virus Screening Rates in Patients Receiving Immunosuppressive Therapy

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Abstract

Background and Aims

Hepatitis B reactivation in patients undergoing immunosuppressive therapy can lead to liver failure and death. Prior studies have shown suboptimal hepatitis B screening rates, but few have compared screening rates across specialties or factors associated with screening.

Methods

A retrospective study was performed using a hospital-based chemotherapy database and outpatient pharmacy records from January 1999 to December 2013. HBV screening rates prior to initiation of immunosuppression were determined. Multivariate analysis was used to determine predictors of HBV screening.

Results

Of the 4008 study patients, 47 % were screened prior to receiving immunosuppressive therapy; only 48 % on rituximab and 45 % of those on anti-TNF therapy were screened. Transplant specialists screened most frequently (85 %) while gastroenterologists screened the least (34 %). Factors significantly associated with HBV screening were younger age, Asian race, use of anti-rejection therapy, and treatment by a transplant specialist (p < 0.001).

Conclusion

HBV screening prior to immunosuppressive therapy is suboptimal, especially among gastroenterologists. Efforts to improve screening rates in at risk populations are needed.

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Acknowledgments

S. Paul received grant support through the 2013-2014 Bristol-Myers Squibb Virology Research Training Program. This project was also supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), Grant Nos. UL1 TR001064 and UL1 TR000073. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Massachusetts General Hospital, 55 Fruit Street, Blake 4, Boston, MA, 02114, USA

    Sonali Paul

  2. Department of Gastroenterology, University of Florida College of Medicine, 655 West 8th Street, Jacksonville, FL, 23309, USA

    Asim Shuja

  3. Department of Gastroenterology and Hepatology, Tufts Medical Center, 800 Washington Street, Box #233, Boston, MA, 02111, USA

    Idy Tam, Eun Min Kim & Kathleen Viveiros

  4. Tufts University School of Medicine, 145 Harrison Street, Boston, MA, 02111, USA

    Sandra Kang & Leonid Kapulsky

  5. Division of Gastroenterology and Hepatology, Virginia Commonwealth University Medical Center, 1101 East Marshall Street, Richmond, VA, 23298-0663, USA

    Hannah Lee

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  1. Sonali Paul
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Correspondence to Sonali Paul.

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Paul, S., Shuja, A., Tam, I. et al. Gastroenterologists Have Suboptimal Hepatitis B Virus Screening Rates in Patients Receiving Immunosuppressive Therapy. Dig Dis Sci 61, 2236–2241 (2016). https://doi.org/10.1007/s10620-016-4118-1

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  • DOI: https://doi.org/10.1007/s10620-016-4118-1

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