Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional study
Abstract Background Hepatitis B, hepatitis C, cytomegalovirus (CMV), and tuberculosis (TB) pose significant risks to patients with inflammatory bowel disease (IBD) receiving biological therapy. However, data on the prevalence of these infections in Syria are scarce. Methods We conducted a retrospect...
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BMC
2025-05-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-11063-6 |
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| author | Marouf Alhalabi Hussam Aldeen Alshiekh Shadi Alsaiad Mouayad Zarzar |
| author_facet | Marouf Alhalabi Hussam Aldeen Alshiekh Shadi Alsaiad Mouayad Zarzar |
| author_sort | Marouf Alhalabi |
| collection | DOAJ |
| description | Abstract Background Hepatitis B, hepatitis C, cytomegalovirus (CMV), and tuberculosis (TB) pose significant risks to patients with inflammatory bowel disease (IBD) receiving biological therapy. However, data on the prevalence of these infections in Syria are scarce. Methods We conducted a retrospective chart review of IBD patients receiving biologic therapy at Damascus Hospital and Ibn Al-Nafees Hospital, two major public institutions in Syria, between January 2021 and November 2024. A minimum sample size of 130 was estimated; however, all available records were reviewed. Results Among 185 IBD patients (104 from Damascus and 81 from Ibn Al-Nafees), 51.4% had ulcerative colitis and 47.6% had Crohn’s disease. The smoking prevalence was 9.2%, which was higher in Crohn’s disease (5.9%) than in ulcerative colitis (3.2%). TST performed in 61.1% of patients, with 4.3% positivity, and interferon-gamma release assay (IGRA) in 8.7% (1.1% positive). Hepatitis B surface antigen (HBsAg) and anti-HBc antibodies were found in 2.7% and 5.4% of the patients, respectively, while hepatitis C seroprevalence was low (0.5%). CMV seropositivity was high in Damascus (50.8%), with two cases (1.1%) of CMV colitis. Biologic therapies included infliximab (42.7%), ustekinumab (24.3%), golimumab (10.8%), and adalimumab (6.5%). Data gaps, particularly in viral serology and TB screening, are notable. Conclusion This study identifies deficiencies in TB/hepatitis B screening (notably anti-HBs Ab) and elevated CMV seroprevalence among Syrian IBD patients receiving biologics, extending to immunosuppressed cohorts (rheumatology, dermatology, oncology). Insufficient screening heightens occult infection/reactivation risks, necessitating standardized pretreatment protocols to reduce morbidity in high-risk populations. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-fd8a52c7cd7b46248f0a5476ef4f042e |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-fd8a52c7cd7b46248f0a5476ef4f042e2025-08-20T03:53:08ZengBMCBMC Infectious Diseases1471-23342025-05-012511910.1186/s12879-025-11063-6Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional studyMarouf Alhalabi0Hussam Aldeen Alshiekh1Shadi Alsaiad2Mouayad Zarzar3Gastroenterologist at Gastroenterology Department of Damascus HospitalGastroenterology Department of Ibn Al-Nafees HospitalGastroenterologist at Gastroenterology Department of Damascus HospitalGastroenterologist at Gastroenterology Department of Damascus HospitalAbstract Background Hepatitis B, hepatitis C, cytomegalovirus (CMV), and tuberculosis (TB) pose significant risks to patients with inflammatory bowel disease (IBD) receiving biological therapy. However, data on the prevalence of these infections in Syria are scarce. Methods We conducted a retrospective chart review of IBD patients receiving biologic therapy at Damascus Hospital and Ibn Al-Nafees Hospital, two major public institutions in Syria, between January 2021 and November 2024. A minimum sample size of 130 was estimated; however, all available records were reviewed. Results Among 185 IBD patients (104 from Damascus and 81 from Ibn Al-Nafees), 51.4% had ulcerative colitis and 47.6% had Crohn’s disease. The smoking prevalence was 9.2%, which was higher in Crohn’s disease (5.9%) than in ulcerative colitis (3.2%). TST performed in 61.1% of patients, with 4.3% positivity, and interferon-gamma release assay (IGRA) in 8.7% (1.1% positive). Hepatitis B surface antigen (HBsAg) and anti-HBc antibodies were found in 2.7% and 5.4% of the patients, respectively, while hepatitis C seroprevalence was low (0.5%). CMV seropositivity was high in Damascus (50.8%), with two cases (1.1%) of CMV colitis. Biologic therapies included infliximab (42.7%), ustekinumab (24.3%), golimumab (10.8%), and adalimumab (6.5%). Data gaps, particularly in viral serology and TB screening, are notable. Conclusion This study identifies deficiencies in TB/hepatitis B screening (notably anti-HBs Ab) and elevated CMV seroprevalence among Syrian IBD patients receiving biologics, extending to immunosuppressed cohorts (rheumatology, dermatology, oncology). Insufficient screening heightens occult infection/reactivation risks, necessitating standardized pretreatment protocols to reduce morbidity in high-risk populations. Clinical trial number Not applicable.https://doi.org/10.1186/s12879-025-11063-6Ulcerative colitisCrohn's diseaseInflammatory bowel diseaseHepatitis BHepatitis CTuberculosis |
| spellingShingle | Marouf Alhalabi Hussam Aldeen Alshiekh Shadi Alsaiad Mouayad Zarzar Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional study BMC Infectious Diseases Ulcerative colitis Crohn's disease Inflammatory bowel disease Hepatitis B Hepatitis C Tuberculosis |
| title | Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional study |
| title_full | Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional study |
| title_fullStr | Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional study |
| title_full_unstemmed | Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional study |
| title_short | Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional study |
| title_sort | prevalence of opportunistic infections in syrian inflammatory bowel disease patients on biologic therapy a multi center retrospective cross sectional study |
| topic | Ulcerative colitis Crohn's disease Inflammatory bowel disease Hepatitis B Hepatitis C Tuberculosis |
| url | https://doi.org/10.1186/s12879-025-11063-6 |
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