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台湾炎症性肠病患者肝炎的血清学评估:一项回顾性队列分析

Serological Assessment of Hepatitis in Patients with Inflammatory Bowel Disease in Taiwan: A Retrospective Cohort Analysis.

作者信息

Lee Yueh-An, Yen Hsu-Heng, Chen Yang-Yuan

机构信息

Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan.

Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan.

出版信息

Life (Basel). 2025 May 31;15(6):893. doi: 10.3390/life15060893.

Abstract

Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn's disease (CD), is a chronic, immune-mediated inflammatory disorder of the gastrointestinal tract. Immunosuppressive therapy administration increases the risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) reactivation. This study aimed to investigate the hepatitis screening rate, serological status, and protective antibody levels among the Taiwanese IBD population. This single-center retrospective study included patients with IBD from January 2016 to December 2024. Hepatitis serological markers were analyzed. Patients were categorized into active HBV infection (HBsAg-positive), resolved HBV infection (HBsAg-negative and anti-HBc-positive), and non-HBV-infected groups, with prevalences of 7.5%, 32.5%, and 0.9%, respectively. This study included 347 patients with IBD (UC: 68.3%; CD: 31.7%), with a mean age of 47.1 ± 16.4 years. Patients born after 1984 demonstrated a significantly reduced HBsAg positivity (0.9% vs. 11.0%; < 0.05) and resolved HBV infection (52.2% vs. 1.0%; < 0.05). However, among non-HBV-infected individuals, only 42.0% had protective anti-HBs levels (≥10 mIU/mL), despite vaccination program initiation. In this study, we found an overall HBsAg positivity rate of 7.5% and an anti-HCV seropositivity rate of 0.9% in our IBD population. Taiwan's HBV vaccination program has effectively reduced the HBV prevalence. However, a significant proportion of vaccinated individuals lack sufficient protective antibody levels, thereby requiring continued HBV screening and booster vaccinations.

摘要

炎症性肠病(IBD)包括溃疡性结肠炎(UC)和克罗恩病(CD),是一种慢性的、免疫介导的胃肠道炎性疾病。免疫抑制治疗会增加乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)重新激活的风险。本研究旨在调查台湾IBD人群中的肝炎筛查率、血清学状态和保护性抗体水平。这项单中心回顾性研究纳入了2016年1月至2024年12月期间的IBD患者。对肝炎血清学标志物进行了分析。患者被分为活动性HBV感染(HBsAg阳性)、已治愈的HBV感染(HBsAg阴性且抗-HBc阳性)和未感染HBV组,其患病率分别为7.5%、32.5%和0.9%。本研究纳入了IBD患者347例(UC:68.3%;CD:31.7%),平均年龄为47.1±16.4岁。1984年后出生的患者HBsAg阳性率(0.9%对11.0%;<0.05)和已治愈的HBV感染率(52.2%对1.0%;<0.05)显著降低。然而,在未感染HBV的个体中,尽管启动了疫苗接种计划,但只有42.0%的人具有保护性抗-HBs水平(≥10 mIU/mL)。在本研究中,我们发现IBD人群中总体HBsAg阳性率为7.5%,抗-HCV血清阳性率为0.9%。台湾的HBV疫苗接种计划有效降低了HBV患病率。然而,相当一部分接种疫苗的个体缺乏足够的保护性抗体水平,因此需要继续进行HBV筛查和加强接种。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0b5/12194725/431b24394c3e/life-15-00893-g001.jpg

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