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<p><b>Introduction:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusion:</b> 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.</p>

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

  • 期刊论文

  • 发表日期：

    2025年1月3日

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  • 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

摘要

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.