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However, data on the prevalence of these infections in Syria are scarce.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among 185 IBD patients (104 from Damascus and 81 from Ibn Al-Nafees), 51.4% had ulcerative colitis and 47.6% had Crohn\u2019s disease. The smoking prevalence was 9.2%, which was higher in Crohn\u2019s 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical trial number<\/jats:title>\n            <jats:p>Not applicable.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12879-025-11063-6","type":"journal-article","created":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T17:17:49Z","timestamp":1746379069000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence of opportunistic infections in Syrian inflammatory bowel disease patients on biologic therapy: a multi-center retrospective cross-sectional study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5027-2096","authenticated-orcid":false,"given":"Marouf","family":"Alhalabi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8078-2830","authenticated-orcid":false,"given":"Hussam Aldeen","family":"Alshiekh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0658-6751","authenticated-orcid":false,"given":"Shadi","family":"Alsaiad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4887-2321","authenticated-orcid":false,"given":"Mouayad","family":"Zarzar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,4]]},"reference":[{"key":"11063_CR1","doi-asserted-by":"crossref","unstructured":"Olaru ID, Meier MB, Mirzayev F, Prodanovic N, Kitchen PJ, Schumacher SG et al. 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The Institutional Review Board and Research Ethics Committee at Damascus Hospital provided ethical approval for this retrospective cross-sectional study (approval number: EAN:4\u22122024). The Institutional Review Board and Research Ethics Committee at Damascus Hospital waived participants\u2019 written informed permission because of the study\u2019s retrospective design and use of fully anonymised data from pre-existing medical records. This conclusion is consistent with institutional regulations that allow for such usage of anonymised data without obtaining individual agreement. 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