Anyone have latent TB and on Ocrevus?

[erash]

I am a PPD converter which means my TB test is + because at some point (likely because I worked in health care) I was exposed to TB. I do not have active TB but long ago ( before MS) I chose not to take the preventive treatment for latent TB (too many side effects). However there is a small chance that the TB virus can become active, esp. with immune suppression.

Somewhere I read that TB is a risk with specific DMTs, such as Ocrevus. And while my neuro checked my Hep B status, they did not discuss the latent TB that's likely buried in my chart. Has this been an issue for anyone? TIA

[kdali]

I’m still negative. Most people don’t know if they have been exposed, and they are not checking for that before they give it. This could become a problem! I hope you find an answer and share it. I didn’t dive in, but searching for Rituximab and TB pulled up some interesting and seemingly positive articles about reactivation and latent.

Are you considering this med?

[erash in reply to kdali]

I am...because I’m spms, my neuro says it’s my only dmt option but he/she r not seeing universally + results in spms.

I have twice this year had good responses to steroid infusions which is possible but not frequent in spms. So I wonder about where I am in that continuum of MS disease?

[kdali in reply to erash]

Best not to wonder later on if it could have helped? I hope you have fantastic results! 🤗 and no TB of course 😵

[kdali]

I have a question for you! My Hep B titer came back low and my husband was telling me I needed to be revaccinated. I’m retired now though, and as far as I know, nursing was the only reason I needed it. Am I wrong?

[erash in reply to kdali]

The general rule for people without MS is if the first time you measure hep b it’s comes back non-immune you revaccinate with one shot and if they continue to come back not immune you just leave it alone and assume that their immune response is not going to mount a Enuf antibodies to show up positive on the test But they still may be able to ward off the virus

[kdali in reply to erash]

Thank you! I guess he’s right then, as usual 🙄😂🤪

Another question! How long after getting O infused would you get a vaccine? HepB or flu? I don’t see my neuro for a month and I’ll forget I had this question by then if I don’t ask now.

[erash in reply to kdali]

I know 6 weeks before an infusion I don’t know how long after but that’s a great ?

[erash in reply to kdali]

But the recs for hep b revaccination are for people without MS

[kdali in reply to erash]

Thank you!

[Iona60 in reply to kdali]

I was due for the 2nd pneumonia vaccine and my PC checked with the drug rep. It was recommended to be given 2 weeks before next infusion, which I had.

[erash]

I was thinking of asking for the blood test as it is more sensitive. My skin test was 20 yrs ago

[kdali]

Good to know! I was not tested for TB. I wonder if it’s just my neuro’s office dropping another ball, 🤔 🤷‍♀️

Have you redone your vaccines since retiring?

[erash in reply to kdali]

My neuro did not mention but I’m going to ask at my Monday visit

[kdali]

I had none of those drawn!

[erash]

Ok, my neuro hadn’t even heard of the new shingles vaccine until I mentioned it to him. And online neurologist said he is not keen on shingrix but his reasoning Didn’t necessarily make sense to me?

[erash]

If ur varicella came back non- immune would they have given u varivax which is a live vaccine or shingrix?

[Iona60]

I had the TB test before gilenya, which I assume, was why they didn't do it before ocrevus. Just hep and varicella. He didn't say which shingles vaccine he would use, but just that I would need to wait 6 weeks before being o, if I needed one. The latent TB would put me in a quandary erash