Dermatologists' awareness of and screening practices for hepatitis B virus infection before initiating tumor necrosis factor-α inhibitor therapy

Jonathan Stine, Michael Bass, Dalia Ibrahim, Omar S. Khokhar, James H. Lewis

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVE: The aim of the study was to assess dermatologists' awareness of available guidelines and drug package insert information on the screening for and management of hepatitis B (HBV) infection in patients receiving tumor necrosis factor-α inhibitor (TNF-αI) drug therapies for dermatological disorders. MATERIALS AND METHODS: An electronic descriptive cross-sectional questionnaire was administered to a random, nationwide sample of physician members of the American Academy of Dermatology. Each participating physician answered 8 questions regarding his or her awareness of the risk of HBV reactivation. RESULTS: More than half of the dermatologists surveyed (52%) were aware of guidelines regarding TNF-αI use in dermatological disorders. Dermatologists who were aware of the guidelines performed universal screening 81% of the time versus 3% of those who were unaware. Approximately 30% of the dermatologists were aware of drug manufacturers' package insert warnings for risk of HBV reactivation with TNF-αIs. Screening in their high-risk patients was highly variable because >90% performed screening in patients with a history of hepatitis or with elevated liver-associated enzymes. Most (73%) screened appropriately with HB surface antigen. One case of HBV reactivation was observed with infliximab use for psoriasis treatment. CONCLUSIONS: Based on this survey, improving education among dermatologists regarding the risks of HBV reactivation and its prevention for patients receiving TNF-αI seems warranted. More specific consensus guidelines are recommended to achieve universal screening as the standard of care in these patients.

Original languageEnglish (US)
Pages (from-to)781-788
Number of pages8
JournalSouthern Medical Journal
Volume104
Issue number12
DOIs
StatePublished - Dec 1 2011

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Virus Diseases
Hepatitis B virus
Tumor Necrosis Factor-alpha
Drug Labeling
Guidelines
Physicians
Therapeutics
Surface Antigens
Standard of Care
Hepatitis B
Psoriasis
Hepatitis
Dermatologists
Education
Drug Therapy
Liver
Enzymes
Infection
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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abstract = "OBJECTIVE: The aim of the study was to assess dermatologists' awareness of available guidelines and drug package insert information on the screening for and management of hepatitis B (HBV) infection in patients receiving tumor necrosis factor-α inhibitor (TNF-αI) drug therapies for dermatological disorders. MATERIALS AND METHODS: An electronic descriptive cross-sectional questionnaire was administered to a random, nationwide sample of physician members of the American Academy of Dermatology. Each participating physician answered 8 questions regarding his or her awareness of the risk of HBV reactivation. RESULTS: More than half of the dermatologists surveyed (52{\%}) were aware of guidelines regarding TNF-αI use in dermatological disorders. Dermatologists who were aware of the guidelines performed universal screening 81{\%} of the time versus 3{\%} of those who were unaware. Approximately 30{\%} of the dermatologists were aware of drug manufacturers' package insert warnings for risk of HBV reactivation with TNF-αIs. Screening in their high-risk patients was highly variable because >90{\%} performed screening in patients with a history of hepatitis or with elevated liver-associated enzymes. Most (73{\%}) screened appropriately with HB surface antigen. One case of HBV reactivation was observed with infliximab use for psoriasis treatment. CONCLUSIONS: Based on this survey, improving education among dermatologists regarding the risks of HBV reactivation and its prevention for patients receiving TNF-αI seems warranted. More specific consensus guidelines are recommended to achieve universal screening as the standard of care in these patients.",
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Dermatologists' awareness of and screening practices for hepatitis B virus infection before initiating tumor necrosis factor-α inhibitor therapy. / Stine, Jonathan; Bass, Michael; Ibrahim, Dalia; Khokhar, Omar S.; Lewis, James H.

In: Southern Medical Journal, Vol. 104, No. 12, 01.12.2011, p. 781-788.

Research output: Contribution to journalArticle

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