A Danish nationwide questionnaire study of hepatitis B virus screening before immunosuppressive therapy

Difficulty in identifying patients who are at risk for hepatitis B virus (HBV) reactivation makes it import-ant to screen for HBV before initiating immunosuppressive therapy. The aim of this study was to investigate screening procedures for HBV infection before initiation of immunosuppressive therapy and to explore HBV treatment strategies.

All Danish units of haematology, oncology, dermatology, rheumatology and gastroenterology using immunosuppressive agents were invited to fill out a questionnaire for The Danish Database for Hepatitis B and C.

A total of 28 (53%) of the 53 included units answered the questionnaire, of which 25 (89.3%) had a guideline regarding screening for HBV serological markers prior to immunosuppressive therapy, but only ten (37%) had a guideline that is in line with the joint guidelines from the national Danish Societies of Infectious Diseases and Gastroenterology and Hepatology. Nineteen (76%) units had a strategy regarding treatment for reactivation before initiating immunosuppressive therapy in case of positive HBV serology. It was not possible to determine the number of HBV reactivations as this was not registered in the ICD-10 system. The Danish Medicines Agency had one report of reactivation.

A minority of the units had screening guidelines for HBV reactivation that were in line with the guidelines of the national scientific societies. Screening in accordance with these recommendations should be a goal for all Danish units in order to prevent HBV reactivation.

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