Evidence map›Paper›PMID 41023696›Full record

Observational studyBMC infectious diseases2025

Intermittent loss of anti-HBc antibodies in people with multiple sclerosis undergoing disease-modifying therapies.

Patrizia Pasculli, Yann Collins Fosso Ngangue, Maria Antonella Zingaropoli, Federica Dominelli, Federica Ciccone, Michele Antonacci, Gina Ferrazzano, Roberta Campagna, Ombretta Turriziani, Guido Antonelli and 3 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Patrizia PasculliDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Yann Collins Fosso NgangueDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. yanncollins.fosso@uniroma1.it.
Maria Antonella ZingaropoliDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Federica DominelliDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Federica CicconeDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Michele AntonacciDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Gina FerrazzanoDepartment of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Roberta CampagnaDepartment of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
Ombretta TurrizianiDepartment of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
Guido AntonelliDepartment of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
Claudio Maria MastroianniDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Antonella ConteDepartment of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Maria Rosa CiardiDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDisease-modifying therapies (DMTs) are widely used in the treatment of multiple sclerosis (MS). A mounting body of evidence suggests that the risk of hepatitis B virus (HBV) reactivation is primary associated with anti-CD20 therapies. HBV infection leads to the development of anti-HBc antibodies, which typically persist for life. However, the existing literature also highlights the intermittent loss of anti-HBc antibodies in certain immunocompromised individuals. The present study aims to gather real-world evidence on the risk of infection in people with MS (pwMS) prior to the initiation or modification of DMTs, with a particular focus on HBV reactivation and the dynamics of anti-HBc antibody levels in this population. MATERIALS AND

methodsAt the Neuroinfectious Unit, pwMS were longitudinally evaluated for infectious risk before starting, switching, or during DMTs, with a particular focus on the course of anti-HBc antibodies over time during anti-CD20 treatment.

resultsA seven-year retrospective and observational study was conducted, with 318 pwMS enrolled (183 females and 135 males, with a median age [interquartile range, IQR] of 51 [41-60] years). Among 110 anti-CD20 treated pwMS, 15 were anti-HBc positive, with negative or positive HBsAg, and positive or negative anti-HBs antibodies. In 2/15 of pwMS HBsAg was positive, detectable HBV-DNA was found in blood and start specific antiviral therapy before DMT. During anti-CD20 therapy, four out of the fifteen pwMS showed a transient loss of anti-HBc following the start of anti-CD20 treatment. Moreover, during this seven-year retrospective and observational study, two pwMS showed HBV reactivation.

conclusionsThe findings of this observational cohort study demonstrated the intermittent loss of anti-HBc antibodies in pwMS during anti-CD20 therapy. It is imperative that infectious disease screening is performed on pwMS before starting DMTs to define the serological profile and to mitigate the risk of infection, allowing for the avoidance of discontinuing MS therapy and guaranteeing a higher degree of safety.

trial registrationClinical trial number: not applicable.

Indexed as

Hepatitis BHepatitis B AntibodiesHepatitis B Core AntigensMultiple SclerosisAdultFemaleHepatitis B virusHumansLongitudinal StudiesMaleMiddle AgedRetrospective StudiesVirus ActivationHepatitis B AntibodiesHepatitis B Core AntigensAnti-CD20 therapyAnti-HBcDisease-modifying therapiesHepatitis b virusInfectious diseasesMultiple sclerosis

Identifiers

PMID41023696
PMCPMC12482589

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.