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International Journal of Clinical Pharmacy

, Volume 40, Issue 1, pp 169–174 | Cite as

The prevalence and risk factors of hepatitis B flares in chronic hepatitis B patients receiving glucocorticoid pulse therapy

  • Ying-Cheng Lin
  • Shou-Wu Lee
  • Hong-Zen Yeh
  • Chi-Sen Chang
  • Sheng-Shun YangEmail author
Research Article
  • 183 Downloads

Abstract

Background The frequency and risks of hepatitis B reactivation in patients receiving glucocorticoid pulse therapy has not been reported. Objective The aim of our study was to investigate the possibility of glucocorticoid pulse therapy related hepatitis B flare. Setting A Taiwanese tertiary hospital. Methods Chronic hepatitis B patients underwent glucocorticoid pulse therapy were retrospectively collected. The prevalence of hepatitis B flare was counted, and the statistic analysis with logistic regression was adapted to assess the associated risk factors. Main outcome measure The prevalence and associated risk factors of the individuals with hepatitis B flare after glucocorticoid pulse therapy were collected and analyzed. Results A total of 112 patients were identified. Forty patients had received prophylactic antiviral therapy and none of them developed hepatitis B flare. Among the 72 patients who had not received antiviral prophylaxis, 11 of them (15.3%) experienced hepatitis B flares. Those individuals with hepatitis B flares, comparing to those without, were younger (37.4 ± 13.3 vs. 46.0 ± 11.1, p = 0.038), had higher ratio of HBeAg positivity (50 vs. 15.9%, p = 0.017), higher percentage of high hepatitis B viral load (81.8 vs. 8.3%, p = 0.002), higher maintenance glucocorticoid dose (prednisone or equivalent 22.7 ± 14.9 vs. 10.7 ± 12.4 mg, p = 0.003) and higher ratio of cyclophosphamide use (27.3 vs. 1.6%, p = 0.010). After multivariate analysis, only higher dose of maintenance glucocorticoid was related to hepatitis B flare (odds ratio, 1.08; 95% CI, 1.01–1.16). Conclusion A higher maintenance glucocorticoid dosage is associated with the risk of hepatitis B flare after glucocorticoid pulse therapy. No hepatitis B flare occurred in patients receiving prophylactic antiviral therapy before glucocorticoid pulse therapy.

Keywords

Glucocorticoid pulse therapy HBV Hepatitis B flare Immunosuppressive therapy 

Notes

Acknowledgements

The authors would like to thank the support from Clinical Informatics Research and Development Center of Taichung Veterans General Hospital.

Funding

This project received no special funding.

Conflicts of interest

The authors declare that there are no conflicts of interest.

Supplementary material

11096_2017_584_MOESM1_ESM.pdf (92 kb)
Supplementary material 1 (PDF 91 kb)
11096_2017_584_MOESM2_ESM.pdf (118 kb)
Supplementary material 2 (PDF 117 kb)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ying-Cheng Lin
    • 1
  • Shou-Wu Lee
    • 1
    • 2
  • Hong-Zen Yeh
    • 1
    • 3
  • Chi-Sen Chang
    • 1
    • 2
  • Sheng-Shun Yang
    • 1
    • 3
    Email author
  1. 1.Division of Gastroenterology and Hepatology, Department of Internal MedicineTaichung Veterans General HospitalTaichungTaiwan
  2. 2.School of MedicineChung Shan Medical UniversityTaichungTaiwan
  3. 3.Faculty of Medicine, College of MedicineNational Yang- Ming UniversityTaipeiTaiwan

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