title: Prevalence and factors related to hepatitis B and C in inflammatory bowel disease patients in Spain: a nationwide, multicenter study.
abstract: OBJECTIVE
  Limited information suggests the existence of a high prevalence of hepatitis B (HBV) and C virus (HCV) infection in inflammatory bowel disease (IBD). This knowledge is relevant because the viruses may reactivate under immunosuppressive therapy. The objectives of this study are to assess the prevalence of HBV and HCV infection in IBD, in a nationwide study, and to evaluate associated risk factors.
  
  
  METHODS
  This cross-sectional multicenter study included 2,076 IBD patients, consecutively recruited in 17 Spanish hospitals. Factors related to IBD (severity, invasive procedures, etc.) and to infection (transfusions, drug abuse, etc.) were registered. Independent risk factors for viral infection were evaluated using logistic regression analysis.
  
  
  RESULTS
  Present and/or past HBV and HCV infection was found in 9.7% of patients of both ulcerative colitis (UC) and Crohn's disease (CD) (UC: HBsAg 0.8%, anti-HBc 8%, anti-HCV 1.3%; CD: HBsAg 0.6%, anti-HBc 7.1%, anti-HCV 2.3 %). Effective vaccination (anti-HBs, without anti-HBc) was present in 12% of patients. In multivariate analysis, age (odds ratio (OR) 1.04; 95% confidence interval (CI) 1.02-1.06; P=0.000), family history of hepatitis (OR 2.48; 95% CI 1.3-4.74; P=0.006) and moderate-to-severe IBD disease (OR 2.5; 95% CI 1.02-6.15; P=0.046) were significantly related to HBV, whereas transfusions (OR 2.66; 95% CI 1.2-5.87; P=0.015) and antibiotic use (OR 2.66; 95% CI 1.1-6.3; P=0.03) were significantly related to HCV. The significance for transfusions was lost if they were administered after 1991, when HCV markers became mandatory in blood banks.
  
  
  CONCLUSIONS
  Prevalence of HBV and HCV infection in IBD is similar to that of the general population of reference and lower than that in previously published series. This fact, in addition to the lack of association with invasive procedures, suggests the existence of adequate preventive measures in centers attending to these patients. The low percentage of effective vaccination makes it mandatory to intensify B virus vaccination in IBD.
authors.affiliation: Department of Gastroenterology, Hospital Mútua de Terrassa, Fundació per la Recerca Mútua de Terrassa, Plaça Dr Robert no. 5, Catalonia, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Loras
authors.forename: Cristina
authors.initials: C
authors.lastname: Saro
authors.forename: Ferràn
authors.initials: F
authors.lastname: Gonzalez-Huix
authors.forename: Miguel
authors.initials: M
authors.lastname: Mínguez
authors.forename: Olga
authors.initials: O
authors.lastname: Merino
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.forename: Jesús
authors.initials: J
authors.lastname: Barrio
authors.forename: Antonio
authors.initials: A
authors.lastname: Bernal
authors.forename: Ana
authors.initials: A
authors.lastname: Gutiérrez
authors.forename: Marta
authors.initials: M
authors.lastname: Piqueras
authors.forename: Xavier
authors.initials: X
authors.lastname: Calvet
authors.forename: Montserrat
authors.initials: M
authors.lastname: Andreu
authors.forename: Agueda
authors.initials: A
authors.lastname: Abad
authors.forename: Daniel
authors.initials: D
authors.lastname: Ginard
authors.forename: Luis
authors.initials: L
authors.lastname: Bujanda
authors.forename: Julián
authors.initials: J
authors.lastname: Panés
authors.forename: Miquel
authors.initials: M
authors.lastname: Torres
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Bañares
authors.forename: Josep M
authors.initials: JM
authors.lastname: Viver
authors.forename: Maria
authors.initials: M
authors.lastname: Esteve
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000821:virology*; D008297:Male; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies