Inflammatory bowel disease and hepatitis B and C in Western Balkans: a referral centre study and review of the literature.
OBJECTIVE
There is limited data on IBD patients diagnosed with viral hepatitis B and C. The aim of the study was to assess the prevalence of chronic HBV or HCV infection in IBD patients followed by our centre and to describe and review the course of bowel and liver disease during therapy.


METHODS
Single centre retrospective study on 482 consecutive IBD patients. Laboratory investigation for HBV and HCV was performed with routine methods. Treatment protocols for HBV included IFNa and nucleot(s)ide administration and for HCV combined IFNa and ribavirin.


RESULTS
We diagnosed 15 patients (15/482, 3.1%) with HBV or HCV. Of these, 11 were HBV (11/482, 2.3%) and 4 were HCV (4/482, 0.8%). Nine of eleven HBV patients received antiviral therapy (8 lamivudine, 1 IFNa). Five lamivudine patients were switched to tenofovir and in another one adefovir dipivoxil were added. Bowel disease was in remission in ten of the eleven HBV patients. One patient was diagnosed with carcinoid tumor. Two HCV patients received IFNa that was well tolerated. One HCV patient denied therapy and one died from hepatocellular cancer. Of the seven patients on azathioprine only one achieved sustained response. Four patients on Infliximab achieved bowel disease remission but experienced biochemical or virological flare.


CONCLUSIONS
This study demonstrates that prevalence of HBV and HCV infection in a large IBD cohort from Western Balkans is compared to that of the background population. IBD patients under immunosuppressants may apparently be treated with safety if preventive antiviral treatment is administered.
Hepato-Gastroenterology Unit & Laboratory of Immunology, 1st Division of Internal Medicine, Medical School of Ioannina, Greece.
Konstantinos H
KH
Katsanos
Vasileios E
VE
Tsianos
Christos D
CD
Zois
Heleni
H
Zioga
Ioannis
I
Vagias
Eleftheria
E
Zervou
Dimitrios K
DK
Christodoulou
Epameinondas V
EV
Tsianos
D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications / Q000453:epidemiology; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D006115:Greece / Q000453:epidemiology; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000453:epidemiology; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use; D019259:Lamivudine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D015995:Prevalence; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use; D000068698:Tenofovir; D016896:Treatment Outcome
D000998:Antiviral Agents; D016898:Interferon-alpha; D063065:Organophosphonates; D019259:Lamivudine; D012254:Ribavirin; D000068698:Tenofovir; D000225:Adenine; C106812:adefovir dipivoxil