- •Anti-CD20 drugs are associated with a loss of seroprotection against HBV in a short-interval follow-up.
- •It might be beneficial to re-test HBV serology regularly in patients under anti-CD20 drugs.
- •The use of booster vaccine doses and patient education and counseling regarding risk behaviors related to hepatitis B virus infection might have a role in patients under-CD20 drugs that lose seroprotection.
- •We could not identify an increased risk of VZV seroprotection loss with any DMT.
Strategies recommended to decrease the risk of infection associated with the use of multiple sclerosis disease-modifying treatments include screening and immunization against common viral infections such as varicella-zoster (VZV) and hepatitis B (HBV). However, the data concerning the durability of those vaccine responses and the need for re-test is scarce.
We aimed to evaluate HBV and VZV seroprotection loss in MS patients under DMT.
We conducted a cohort study including patients with basal seroprotective titers against HBV/VZV viruses and a subsequent serology performed at least 3 months apart. We evaluated predictors of seroprotection loss through a binary regression.
HBV seroprotection loss occurred in one-fifth of patients in a median interval of 21.3 months. Anti-CD20 treatment (OR 8.559 95%CI 3.467– 21.130, p < 000.1), age at last serology higher or equal to 55 years (OR 7.506, 95% CI 2.473-22.786, p < 0.001) and basal HBsAb titer (OR 0.992, 95%CI 0.987 -0.996, p=0.001) increase the risk of seroprotection loss. VZV seroprotection loss occurred rarely in a median interval of 21.3 months. We could not identify any factor associated with an increased risk of VZV seroprotection loss.
Anti-CD20 drugs are associated with a loss of seroprotection against HBV in a short-interval follow-up.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Multiple Sclerosis and Related Disorders
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Persistence of immunity to live attenuated varicella vaccine in healthy adults.Clin. Infect. Dis. 2002; 34: 774-779
- Management of hepatitis B virus prophylaxis in patients treated with disease-modifying therapies for multiple sclerosis: a multicentric Italian retrospective study.J. Neurol. 2022; 269 (Available at): 3301-3307https://doi.org/10.1007/s00415-022-11009-x
- Factors influencing the durability of hepatitis B vaccine responses.Vaccine. 2021; 39 (Available at): 5224-5230https://doi.org/10.1016/j.vaccine.2021.07.017
- Paradigm shifts: Early initiation of high-efficacy disease-modifying treatment in multiple sclerosis.Mult. Scler. J. 2021; 27: 1473-1476
- Vaccinations in patients with multiple sclerosis: a Delphi consensus statement.Mult. Scler. J. 2020; : 1-13
- Is antibody titer useful to verify the immunization after VZV Vaccine in MS patients treated with Fingolimod? A case series.Mult. Scler. Relat. Disord. 2020; 40 (Available at)101963https://doi.org/10.1016/j.msard.2020.101963
- Changes in hepatitis B virus surface antibody titer and risk of hepatitis B reactivation in HBsAg-negative/HBcAb-positive patients undergoing biologic therapy for rheumatic diseases: a prospective cohort study.Arthritis Res. Ther. 2018; 20: 1-8
Published online: December 28, 2022
Accepted: December 26, 2022
Received in revised form: November 22, 2022
Received: August 24, 2022
© 2022 Elsevier B.V. All rights reserved.