Hepatitis B Viral Markers and Immune Status in Patients with Inflammatory Bowel Diseases: A Cross-Sectional Study Using Data Mining Approach

Abstract

Background:

Patients with inflammatory bowel diseases (IBDs) are at high risk of contracting hepatitis B virus (HBV) or its reactivation due to surgical procedures, blood transfusions, and immunosuppressive therapy. Little is known about the HBV immune status in patients with IBD.

Objective:

We aimed to evaluate the HBV serology of adult patients with IBD in Mashhad, northeastern Iran.

Materials and Methods:

A cross-sectional study was conducted among patients with IBD referred from Mashhad gastrointestinal clinics between June 2021 and August 2022. Demographic and other related data were collected. Hepatitis B surface antigen (HBS-Ag), hepatitis B surface antibody (anti-HBS Ab), and hepatitis B core protein antibody (anti-HBC Ab) were measured. Patients were classified into sub-groups of chronic HBV infection, past HBV infection, effective vaccination, and non-immune against HBV. A decision tree (DT) algorithm was applied to analyze data. Results also were performed using SPSS software version 23.0 at a significant level of 0.05.

Results:

90 patients (30 with Crohn’s disease and 60 with ulcerative colitis) with an average age of 40.48±15.1 years were examined. 35.6% were men. The rate of past HBV infection and chronic HBV infection was 4.4% and 1.1%, respectively. Effective vaccination was 31.1%, and non-immunity against HBV was 63.4%. Use of biological agents was significantly higher among subjects with IBDs ≥10 years (P=0.032). The DT model showed that type of therapy, type of disease, and sex have the most effect on effective vaccination development and anti-HBS Ab level.

Conclusion:

We recommend fully vaccinating seronegative patients with IBD before the initiation of immunosuppressive therapy and routinely monitoring anti-HBS Ab levels, especially in patients under combined therapy.