Prevalence of Blood Borne Viral Infections in Patients with Inflammatory Bowel Disease

Abstract

Background: Patients with Inflammatory bowel disease (IBD) often require immunosuppressive therapy and blood transfusions and hence may be a high risk group for blood borne viral infections. The study assessed prevalence of Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV) in IBD patients.

Methods: This retrospective study included 908 consecutive IBD patients (Ulcerative colitis (UC): 581; Crohn’s disease (CD): 327) and 95 patients with Intestinal TB (ITB) as disease controls. Prospectively maintained patient databases were reviewed for viral markers: HBsAg, anti HCV, and HIV (ELISA method). HCV RNA was done in all anti HCV positive patients. The data was compared with available data on community prevalence of these infections in India (HBV: 3.7%; HCV: 1%; HIV: 0.3%).

Results: Prevalence of HBsAg, HCV, and HIV was 2.4%, 1.4%, and 0.1% respectively in IBD patients. In 581 UC patients, prevalence of HBsAg was 2.2% (12/541), HCV was 1.74% (9/517), and HIV was 0.2% (1/499). In 327 CD patients, prevalence of HBsAg was 2.8% (8/288), HCV was 0.7% (2/273), and HIV was 0% (0/277). ITB patients had presence of HBsAg at 6% (4/67), HCV at 1.8% (1/57), and HIV at 1.2% (1/84). One patient had co-infection of HBV and HCV.

Conclusion: Prevalence of HBV (2.4%), HCV (1.4%), and HIV (0.1%) in North Indian IBD patients is similar to the community prevalence. However, if undetected, the high risk of flare after immunosuppressive therapy mandates routine screening of IBD patients for HBV, HCV, and HIV.