The awareness of physicians using biological agents in treatment about hepatitis B virus reactivation.

Öz

Objective: As long as immunosuppressive treatments are widely used, careful monitoring of HBVr is essential. We aimed to measure the awareness of Turkish physicians of certain specialties about the risk of hepatitis B virus reactivation (HBVr), HBV screening methods, prophylactic treatment practices and personal experiences in treating patients with biological agents. Methods: An electronic questionnaire link containing 21 questions about demographics and their applications to HBVr was sent to participants working in the various specialties across the country. Results: 227 participants took our survey (Female: 52.4%, n:119, Male: 47.6%, n:108), and consisted of 70 Hematologists, 65 Rheumatologists, 38 Gastroenterologists, 33 Oncologists, and 21 Dermatologists. We obtained extremely different results. It was found that all specialties are aware that the use of biological agents can cause HBVr (97.8%, n:222/227). Biological agents were used in 96% of the participants and HBVr was detected in 53.7% (Hematologist: 74.3%, Rheumatologist: 53.8%, Oncologist: 45.5%, Gastroenterologist: 44.7%, Dermatologist: 14.3%, p< 0.001). The general opinion was that, screening tests should be used (Gastroenterologist: 47.4%, p< 0.001) and 55.1% awared of how to monitor HBVr (Gastroenterologist: 65.8%, p = 0.06). The duration of antiviral prophylaxis was answered correctly in 70.4% (Hematologist: 82.6%, p = 0.01), the parameters of screening tests in 95.2% (Gastroenterologist: 97.4%, p = 0.52) and the highest risk of reactivation in 93% (Rheumatologist: 96.9%, p = 0.15) and the agent with the highest risk of reactivation in 82.8% of participants (Hematologist: 94.3%, p< 0.001). Conclusion: The opinions of different the clinical disciplines vary according to the profile of patients. Gastroenterologists' perspective on HBVr follow-up and treatment differs markedly from that of other clinical disciplines. However, to create general awareness and manage HBVr, guidelines for specific patient groups are definitely needed.

Anahtar Kelimeler

• hepatitis B virus reactivation
• prophylaxis
• clinical practice
• clinical awareness
• online forum
• biological agents

Tedavide biyolojik ajanlar kullanan hekimlerin hepatit B virüs reaktivasyonu konusundaki farkındalıkları

Öz

Amaç: İmmünsupresif tedaviler yaygın olarak kullanıldığı sürece, HBVr'nin dikkatle izlenmesi esastır. Belirli uzmanlık dallarındaki Türk hekimlerinin, hepatit B virüsü reaktivasyonu (HBVr) riski, HBV tarama yöntemleri, profilaktik tedavi uygulamaları ve biyolojik ajanlarla hasta tedavisindeki kişisel deneyimleri hakkındaki farkındalıklarını ölçmeyi amaçladık. Metod: Ülke genelinde çeşitli uzmanlık alanlarında çalışan katılımcılara, demografik bilgiler ve bunların HBVr uygulamaları hakkında 21 soru içeren bir elektronik anket bağlantısı gönderildi. Bulgular: Anketimize 70 Hematolog, 65 Romatolog, 38 Gastroenterolog, 33 Onkolog ve 21 Dermatolog olmak üzere toplam 227 kişi (Kadın: %52,4, n:119, Erkek: %47,6, n:108) katılmıştır. Son derece farklı sonuçlar elde ettik. Biyolojik ajan kullanımının HBVr'ye neden olabileceğinin tüm uzmanlık dallarınca bilindiği görüldü (%97,8, n:222/227). Katılımcıların %96'sı tedavide biyolojik ajan kullanılmış ve %53,7'si hastalarında HBVr saptanmıştır (Hematolog: %74,3, Romatolog: %53,8, Onkolog: %45,5, Gastroenterolog: %44,7, Dermatolog: %14,3, p< 0,001). Genel kanı tarama testlerinin kullanılması gerektiği (Gastroenterolog: %47,4, p< 0,001) ve %55,1'inin HBVr'nin nasıl izleneceğini bildiği (Gastroenterolog: %65,8, p= 0,06) yönündeydi. Katılımcılar tarafından, antiviral profilaksi süresi %70,4 (Hematolog: %82,6, p=0,01), tarama testlerinin parametreleri %95,2 (Gastroenterolog: %97,4, p=0,52), en yüksek reaktivasyon riski %93 ( Romatolog: %96,9, p=0,15) ve katılımcıların %82,8'inde reaktivasyon riski en yüksek ajan (Hematolog: %94,3, p< 0,001) doğru olarak yanıtlandı. Sonuç: Farklı klinik disiplinlerin görüşleri hasta profiline göre değişmektedir. Gastroenterologların HBVr takibi ve tedavisine bakış açısı, diğer klinik disiplinlerden belirgin şekilde farklıdır. Bununla birlikte, genel farkındalık yaratmak ve HBVr'yi yönetmek için, belirli hasta gruplarına yönelik kılavuzlara kesinlikle ihtiyaç vardır.

Anahtar Kelimeler

• hepatitis B virus reactivation
• prophylaxis
• clinical practice
• clinical awareness
• online forum
• biological agents

Kaynakça

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