The evaluation of neurologists’ awareness on hepatitis B virus reactivation before launching immunosuppressive treatment

Abstract

Background: Individuals encountering hepatitis B virus (HBV) are at risk of hepatitis B virus reactivation (HBVr) when exposed to immunosuppressive (IS) therapy. Here, we aimed to evaluate neurologists’ knowledge on HBVr in patients receiving IS treatment and draw attention to importance of the issue.

Methods: Eighty-six physicians from neurology departments throughout Turkey between 1st March- 30th April 2020 were enrolled.

Results: Of 86 physicians (average age 37.2±7.6 years), 34 (39.5%) were affiliated with university hospitals, 23 (26.7%) in training and research hospitals, and 29 (33.6%) in secondary healthcare centers. While 28 (32.5%) stated following a guideline, 58 (67.4%) declared following no guidelines. Physicians receiving postgraduate training on HBVr administered prophylaxis before IS treatment at a higher rate (p=0.04), and 69 (80.2%) considered all patients receiving any IS treatment should be screened for HBVr. To all participants, patients selected for screening should be tested for HBsAg; 83 (96.6%) and 29 (33.3%) stated patients should be tested for anti-HBs and anti-HBc IgG, respectively.

Conclusion: Given our study findings, rate of screening performed by neurologists to give IS treatment for HBVr and their awareness level on the situation were not found to be sufficient. In addition, two more important factors required to be raised awareness were detected in our study: First, the rate of using anti-HBc in screening is low, and the awareness should be increased in this direction. Secondly, the risk of HBVr should be categorized in terms of IS treatment and host in our country where HBV infection is seen at a high rate, and determining the prophylactic approach is insufficient.