Multiple sclerosis and related disorders · 2026
Evaluating the risk: Hepatitis B virus reactivation in ocrelizumab-treated patients with multiple sclerosis: A single-center experience and review of the literature.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Ozbay Bahadır Orkun, Kulu Uğur, Baştuğ Aliye, Koçak Yusuf, İşbilen Yücel, Aksoy Dürdane
Аннотация
BACKGROUND: Ocrelizumab is a highly effective anti-CD20 monoclonal antibody used in the treatment of multiple sclerosis (MS). However, B-cell depletion may increase the risk of hepatitis B virus (HBV) reactivation, particularly in patients with previous HBV exposure. Real-world data regarding this risk in patients receiving ocrelizumab remain limited.
METHODS: We conducted a retrospective observational cohort study including adult patients with MS who received ocrelizumab between January 2018 and December 2025 at a tertiary referral center. Baseline HBV serological status, antiviral prophylaxis, and follow-up data were reviewed. HBV reactivation was defined according to contemporary international guideline recommendations.
RESULTS: A total of 107 patients were included. The mean age was 42.6 ± 10.9 years, and 54.2% were female. Evidence of previous HBV exposure (anti-HBc positivity) was identified in 10 patients (9.3%), including eight patients with resolved infection and two with isolated anti-HBc positivity. Antiviral prophylaxis was administered to nine of these patients, while one patient was managed with close laboratory monitoring. During a mean ocrelizumab treatment duration of 3.4 ± 2.0 years, no cases of HBV reactivation were observed. No patient developed detectable HBV DNA, detectable hepatitis B surface antigen (HBsAg), or hepatitis attributable to HBV reactivation.
CONCLUSIONS: HBV reactivation was not observed in this real-world cohort of patients with MS receiving ocrelizumab. These findings support the importance of baseline HBV screening, risk stratification, and individualized prophylaxis or monitoring strategies to minimize reactivation risk during anti-CD20 therapy.
METHODS: We conducted a retrospective observational cohort study including adult patients with MS who received ocrelizumab between January 2018 and December 2025 at a tertiary referral center. Baseline HBV serological status, antiviral prophylaxis, and follow-up data were reviewed. HBV reactivation was defined according to contemporary international guideline recommendations.
RESULTS: A total of 107 patients were included. The mean age was 42.6 ± 10.9 years, and 54.2% were female. Evidence of previous HBV exposure (anti-HBc positivity) was identified in 10 patients (9.3%), including eight patients with resolved infection and two with isolated anti-HBc positivity. Antiviral prophylaxis was administered to nine of these patients, while one patient was managed with close laboratory monitoring. During a mean ocrelizumab treatment duration of 3.4 ± 2.0 years, no cases of HBV reactivation were observed. No patient developed detectable HBV DNA, detectable hepatitis B surface antigen (HBsAg), or hepatitis attributable to HBV reactivation.
CONCLUSIONS: HBV reactivation was not observed in this real-world cohort of patients with MS receiving ocrelizumab. These findings support the importance of baseline HBV screening, risk stratification, and individualized prophylaxis or monitoring strategies to minimize reactivation risk during anti-CD20 therapy.