Title: Prevalence of Hepatitis B Among Adults Receiving Immunosuppressive Therapy At a Tertiary Care Center in Saudi Arabia
Background:
Hepatitis B (HB) is a significant threat to global public health. Vaccination is an effective measure to prevent HBV infection and its related complications. However, individuals born before the vaccine's introduction are at a higher risk of chronic HB (CHB) and HBV reactivation.
Purpose:
This study aims to explore the seroprevalence of HBV by measuring HBV blood markers levels including HBsAg, anti-HBs, and anti-HBc among Saudi adults receiving immunosuppressive therapy to assess the risk of HBV reactivation among them as they receive immunosuppressive therapy at a tertiary care referral hospital in Riyadh, Saudi Arabia. . The study also aims to investigate the impact of the HBV vaccine introduction in the Saudi healthcare system 33 years ago in 1990 on the risk of HBV reactivation.
Method:
A retrospective, cross-sectional study obtained patient information from medical records from the Epic system used at King Fahad Medical City (KFMC). The sample included 18 years or older Saudi patients who have been prescribed immunosuppressive therapy from March 2021 to February 2022 in KFMC. HB serology was assessed by screening for HB surface antigen (HBsAg), HB core antibody (anti-HBc), and HB surface antibody (anti-HBs). Then, we stratified the patients into two groups based on age to assess the impact of the HBV vaccination program.
Results:
The overall prevalence of active HBV infection (positive HBsAg) among patients was 0.7%, while the overall prevalence of resolved infection (positive anti-HBc and negative HBsAg and anti-HBs) was 7.4%. The prevalence of functionally cured HBV infection in Group 2 (<33 years) was lower than in Group 1 (>33 years) (0.7% VS. 11.1%, p < 0.0001) and thus have a lower risk of HBV reactivation, proving the effectiveness of the HBV vaccine that started to be administered to infants in 1990.
Conclusion:
In conclusion, our study reveals a notable seroprevalence of hepatitis B virus (HBV) infection among Saudi adult patients receiving immunosuppressive therapy, with 0.7% having active HBV infection. Emphasizing the importance of comprehensive screening and vaccination strategies, such as the HBV vaccination program after 1990, our findings underscore the need for proactive measures to minimize the transmission and complications associated with HBV in this vulnerable population.