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Article Dans Une Revue Alimentary Pharmacology and Therapeutics Année : 2011

Review article: Prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Javier P Gisbert
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María Chaparro
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Maria Esteve
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Résumé

Aim: To review the relationship between inflammatory bowel disease(IBD) and hepatitis B virus(HBV) and hepatitis C virus(HCV) infection. Methods: Bibliographical searches were performed in MEDLINE up to September 2010. Results and Conclusions: 1)The prevalence of both HBV and HCV infection in IBD patients is now similar to that of the general population. 2)All IBD patients should be screened for HBV markers at diagnosis. 3)Liver dysfunction in IBD patients treated with immunosuppressants is more frequent and severe in HBV than in HCV carriers and is associated with combined immunosuppression. 4)In patients receiving anti-TNF drugs, HBV reactivation(which may cause fulminant hepatic failure) is common unless antiviral prophylaxis is administered. 5)HBsAg-positive patients should receive antiviral prophylaxis before starting immunosuppressants. 6)As interferon therapy might worsen underlying IBD, nucleoside/nucleotide analogs are preferred for antiviral prophylaxis in patients with HBV (tenofovir/entecavir are preferred to lamivudine). 7)Patients with IBD should be vaccinated against HBV at diagnosis. 8)The response rate to HBV vaccination seems to be quite low, mainly in those already receiving anti-TNF therapy. 9)The serological response to HBV vaccine should be measured after vaccination. 10)Patients with an inadequate response to the vaccination should receive a second full series of HBV vaccine. 11)If a patient with IBD requires treatment for HCV, the combination of peginterferon plus ribavirin appears to be as effective as in non-IBD patients. 12)No difference in adverse events has been observed between IBD and non-IBD patients treated with interferon for HCV infection. 13)Interferon is generally safe in patients with chronic hepatitis C and IBD.

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Dates et versions

hal-00607702 , version 1 (11-07-2011)

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Javier P Gisbert, María Chaparro, Maria Esteve. Review article: Prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease. Alimentary Pharmacology and Therapeutics, 2011, 33 (6), pp.619. ⟨10.1111/j.1365-2036.2010.04570.x⟩. ⟨hal-00607702⟩

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