风湿病住院患者的慢性乙型肝炎:感染的筛查和再激活问题

G. I. Gridneva, E. S. Aronova, B. S. Belov
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摘要

目的:评价某风湿病医院收治的hbsag阳性患者乙型肝炎病毒(HBV)感染筛查的完整性,并在抗风湿病治疗期间跟踪HBV再激活/血清逆转史。材料和方法。本研究分析了2020年1月1日至2022年7月20日(30个月)在va Nasonova风湿病研究所(va Nasonova Institute of Rheumatology)首次和重复(如果适用)住院治疗的80例风湿病(RD)患者的结果,其中55例(69%)女性和25例(31%)男性携带澳大利亚表面抗原(HBsAg)。结果和讨论。在观察期间,到该诊所住院的总人数为13 681人,包括重复入院。在观察期间,80例HBV感染患者(包括重复入院)的住院人数为144人,其中全身性血管炎6人(8%),其他全身性结缔组织疾病16人(20%),骨关节炎和关节创伤后改变14人(15%),炎症性关节疾病42人(54%)。9例(11%)患者在记忆和观察期间检测到HBV再激活/血清浓度升高,其中最常见的(n = 5)是在甲氨蝶呤治疗期间登记的。结论。由于感染再次激活的风险,RD患者的HBV感染导致了药物治疗选择的重大困难。获得的结果表明,在临床前阶段,RD患者的HBV感染筛查不完全。需要进一步的研究来制定明确的建议,以管理RD感染HBV的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chronic hepatitis B in hospitalized rheumatologic patients: problems of screening and reactivation of infection
Objective: to evaluate the completeness of screening for hepatitis B virus (HBV) infection in HBsAg-positive patients admitted to a rheumatology hospital and to follow the history of HBV reactivation/seroversion during antirheumatic therapy. Material and methods. The results of initial and repeated (if applicable) hospitalizations were analyzed in 80 patients with rheumatic diseases (RD), including 55 (69%) women and 25 (31 %) men, with Australian surface antigen (HBsAg), admitted to the V.A. Nasonova Institute of Rheumatology from January 1, 2020 to July 20, 2022 (30 months). Results and discussion. The total number of hospitalizations to the clinic during the observation period, including repeat admissions, was 13,681. The number of hospitalizations in 80 patients with HBV infection during the observation period, including repeat admissions, was 144, of which for systemic vasculitis – 6 (8 %), other systemic connective tissue diseases – 16 (20 %), osteoarthritis and post-traumatic changes of joints – 14 (15 %), inflammatory joint diseases – 42 (54 %). Cases of HBV reactivation/seroverion, both in anamnesis and during observation, were detected in 9 (11 %) patients, and most frequently (n = 5) they were registered during methotrexate therapy. Conclusion. HBV infection in patients with RD leads to significant difficulties in the selection of drug therapy, due to the risk of reactivation of the infection. The results obtained indicate incomplete screening of patients with RD for HBV infection during the preclinical phase. Further investigation is needed to develop clear recommendations for the management of patients with RD infected with HBV.
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