P1283 Adherence to Infectious Disease Assessment at Baseline in Patients with Inflammatory Bowel Disease: A Retrospective Study from a Medical Center
Authors: Huang C W , Yen H H , Chen Y Y 
Published: January 2025

Background

The prevalence of inflammatory bowel disease (IBD) in Taiwan is increasing, and with a growing understanding of the disease, treatment options for IBD have expanded beyond the use of 5-aminosalicylic acid (5-ASA), immunomodulators, and steroids to include a variety of biologics. However, during the course of medical treatment for IBD patients, the risk of infectious diseases may arise. Therefore, conducting a baseline assessment for infections in IBD patients is crucial. Thus, we conducted this retrospective study on IBD patients at a medical center to assess physicians’ adherence to infection risk assessments in IBD patients.

Methods

This retrospective study enrolled IBD patients from Changhua Christian Hospital from 1995 to 2024 and collected relevant data, including age, gender, IBD classification, types of medications used, and whether testing for HBV, HCV, TB, VZV, and measles was performed. Additionally, we conducted an analysis of factors related to IBD patients who underwent these tests.

Results

This study enrolled a total of 338 patients, with an average age of 45.9 ± 16.1 years. Among them, 62.7% (212/338) were male, and 67.8% had ulcerative colitis (UC). Additionally, 72.5% of the patients were treated by an IBD specialist. Of the patients, 95.0% were tested for HBsAg, 75.1% for anti-HBc IgG, 95.0% for anti-HCV, 49.1% for IGRA, 31.4% for anti-VZV IgG, and 16.3% for anti-measles IgG. UC patients were significantly less likely to be assessed for TB, while physicians specializing in IBD were significantly more likely to evaluate for VZV and measles compared to general physicians. In terms of medication use, 5-ASA did not show any significant difference in infection assessments. However, patients using immunomodulators, steroids, or biologics had a significantly higher rate of TB evaluation, whereas the proportion of patients assessed for VZV, and measles remained significantly low, regardless of the type of medication used.

Conclusion

In conclusion, this study highlights gaps in infection risk assessment among IBD patients. While testing rates for HBV and HCV were high, there was a notable variation in the evaluation of TB, VZV, and measles, particularly among non-IBD specialty physicians. Additionally, the use of immunomodulators, steroids, or biologics was associated with a higher rate of TB evaluation, but VZV and measles assessments remained consistently low across all medication groups. These findings underscore the need for more comprehensive infection screening, especially for VZV and measles, to improve patient safety in IBD management.

References

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