Highlights
- •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.
Abstract
Background
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.
Objectives
We aimed to evaluate HBV and VZV seroprotection loss in MS patients under DMT.
Methods
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.
Results
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.
Conclusions
Anti-CD20 drugs are associated with a loss of seroprotection against HBV in a short-interval
follow-up.
Keywords
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Article info
Publication history
Published online: December 28, 2022
Accepted:
December 26,
2022
Received in revised form:
November 22,
2022
Received:
August 24,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
