High dose biotin impact on HBc test results in patients with primary progressive multiple sclerosis qualified for ocrelizumab treatment Original article

Abstract

Ocrelizumab is the first disease modifying drug approved for use in primary progressive multiple sclerosis. In Poland, it has been available to patients within a drug program financed by the Polish National Health Fund since November 2020. Until ocrelizumab became available, other therapeutic approaches had been tried in primary progressive multiple sclerosis patients, including high doses of biotin administered orally. Ocrelizumab treatment may lead to reactivation of latent HCV or HBV infections. Some immunoassays, including ones widely used in detecting antibodies against hepatitis viruses, utilize a streptavidin-biotin complex reaction, and can give false positive results in patients with high serum biotin concentration. In this paper we want to present our experiences with primary progressive multiple sclerosis patients treated in the Neurology Department of Ludwik Rydygier Specialist Hospital in Krakow, in which high doses of oral biotin led to false positive anti-HBc total results in patients with primary progressive multiple sclerosis during their qualification for ocrelizumab treatment.