Similar Hepatitis B virus reactivation risk for patients with inflammatory arthritis or connective tissue diseases: a multicenter retrospective study.

IF 3.2 3区医学 Q2 RHEUMATOLOGY

Rheumatology International Pub Date : 2025-01-03 DOI:10.1007/s00296-024-05771-6

Maria Pappa, Alexandra Koutsogianni, Anastasios Karamanakos, Niki Kyriazi, Myrto Cheila, Dimitra Moschou, Evangelia Mole, Souzana Gazi, Evangelos Papadimitriou, Fabiola Atzeni, Marco Sebastiani, Ourania D Argyropoulou, Konstantinos D Vasilakis, Charalampos Papagoras, George E Fragoulis, Theodoros Androutsakos

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引用次数: 0

Abstract

Introduction: Hepatitis B reactivation and administration of prophylactic antiviral treatment are considered in patients with autoimmune inflammatory rheumatic diseases (AIIRD) undergoing immunosuppressive/immunomodulatory treatment. Data are more robust for rheumatoid arthritis patients receiving bDMARDs but are limited for other AIIRD and drug categories.

Methods: Adult patients with AIIRD (inflammatory arthritis [IA] or connective tissue diseases [CTD]) and documented chronic or resolved HBV infection (defined as serum HBsAg positivity or anti-HBcAb positivity in the case of HBsAg non-detection respectively), followed-up in six rheumatology centers in Greece and Italy, were included. Data collected included demographic characteristics, AIIRD medications prior and after HBV screening [cs-DMARDs, (b-ts)- DMARDs, other immunosuppressants initiated and mean glucocorticoid dose], HBV prophylactic treatment, and possible HBV-reactivation (defined as increase in HBV-DNA or HBsAg seroconversion) within one year of HBV screening. Frequency of HBV reactivation and possible association with recorded parameters were examined.

Results: During one year of follow-up, HBV reactivation occurred in 5.6% and 7.9% of IA and CTD patients, respectively. In patients with chronic hepatitis B, reactivation rates were 14.8% for IA and 22.2% for CTD, while in patients with resolved hepatitis B were 3.7% and 6%, respectively. In patients with resolved hepatitis B no association was found between HBV reactivation and antiviral prophylactic treatment, or the use of csDMARDs, bDMARDS, or other immunosuppressants.

Conclusion: The risk of HBV reactivation was similar between IA and CTD patients and was significantly higher in chronic compared to resolved hepatitis B infection. For the latter, prophylactic treatment was not associated with lower reactivation risk.

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炎症性关节炎或结缔组织疾病患者相似的乙肝病毒再激活风险：一项多中心回顾性研究

在接受免疫抑制/免疫调节治疗的自身免疫性炎症性风湿病（AIIRD）患者中，乙肝再激活和预防性抗病毒治疗被考虑。类风湿性关节炎患者接受bdmard治疗的数据更为可靠，但其他aird和药物类别的数据有限。方法：纳入在希腊和意大利的六个风湿病中心随访的患有AIIRD（炎症性关节炎[IA]或结缔组织疾病[CTD]）并记录慢性或缓解HBV感染（定义为血清HBsAg阳性或抗hbcab阳性，分别为HBsAg未检测到的情况）的成年患者。收集的数据包括人口统计学特征，HBV筛查前后的AIIRD药物[cs-DMARDs， (b-ts)- DMARDs，其他免疫抑制剂起始和平均糖皮质激素剂量]，HBV预防治疗，以及HBV筛查一年内可能的HBV再激活（定义为HBV- dna或HBsAg血清转化增加）。检查了HBV再激活的频率及其与记录参数的可能关联。结果：在一年的随访中，IA和CTD患者的HBV再激活率分别为5.6%和7.9%。在慢性乙型肝炎患者中，IA和CTD的再激活率分别为14.8%和22.2%，而缓解型乙型肝炎患者的再激活率分别为3.7%和6%。在解决的乙型肝炎患者中，HBV再激活与抗病毒预防性治疗或使用csDMARDs、bDMARDS或其他免疫抑制剂之间没有关联。结论：IA和CTD患者HBV再激活的风险相似，慢性乙型肝炎感染的风险明显高于缓解型乙型肝炎感染。对于后者，预防性治疗与较低的再激活风险无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology International 医学-风湿病学

CiteScore

7.30

自引率

5.00%

发文量

191

审稿时长

16. months

期刊介绍： RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.