ISSN 2147-9720 | E-ISSN 2148-4279
Original Article
Current antiviral practice and course of Hepatitis B virus infection in inflammatory arthritis: a multicentric observational study (A + HBV study)
1 Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey  
2 Department of Internal Medicine, Division of Rheumatology, Ege University Faculty of Medicine, İzmir, Turkey  
3 Department of Internal Medicine, Division of Rheumatology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey  
4 Division of Rheumatology, Gülhane Military Faculty of Medicine, Ankara, Turkey  
5 Department of Internal Medicine, Division of Rheumatology, Osmangazi University, Faculty of Medicine, Eskişehir, Turkey  
6 Department of Internal Medicine, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey  
7 Department of Internal Medicine, Division of Rheumatology, Marmara University Faculty of Medicine, İstanbul, Turkey  
8 Department of Internal Medicine, Division of Rheumatology, Çukurova University Faculty of Medicine, Adana, Turkey  
9 Department of Internal Medicine, Division of Rheumatology, Ankara University Faculty of Medicine, Ankara, Turkey  
10 Division of Rheumatology, Diyarbakır Goverment Hospital, Diyarbakır, Turkey  
11 Department of Internal Medicine, Division of Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey  
12 Department of Internal Medicine, Division of Rheumatology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey  
13 Department of Internal Medicine, Division of Rheumatology, Antalya University Faculty of Medicine, Antalya, Turkey  
14 Department of Internal Medicine, Division of Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey  
15 Department of Internal Medicine, Division of Rheumatology, İzmir Atatürk Training and Research Hospital, İzmir, Turkey  
16 Department of Internal Medicine, Division of Rheumatology, Ankara Atatürk Education and Research Hospital, Ankara, Turkey  
17 Department of Internal Medicine, Division of Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey  
18 Department of Internal Medicine, Division of Rheumatology, Sakarya Education and Research Hospital, Sakarya, Turkey  
19 Department of Internal Medicine, Division of Rheumatology, Cerrahpaşa University, Faculty of Medicine, İstanbul, Turkey  
Eur J Rheumatol 2015; 2: 149-154
DOI: 10.5152/eurjrheum.2015.0111
Key Words: Rheumatoid arthritis, ankylosing spondylitis, hepatitis B infection, hepatitis B reactivation, hepatitis B viral load
Abstract

Objective: The reactivation of hepatitis B virus (HBV) infection is a well-known event in hepatitis B surface antigen (HbsAg)-positive patients receiving immunosuppressive therapy. The objective of this study was to assess the antiviral practice and course of HBV infection in inflammatory arthritis.

 

Material and Methods: Nineteen rheumatology centers participated in this retrospective study. HbsAg-positive patients who were taking disease-modifying antirheumatic drugs and who were being tested for HBV viral load at a minimum of two different time points were included. The case report form (CRF) consisted of demographic data, rheumatic diseases, treatment profiles, transaminase levels, viral hepatitis serological markers, and HBV viral load. The reactivation of HBV was defined as the abrupt rise in HBV replication by an increase in serum HBV DNA levels in a patient with a previously inactive HBV infection.

 

Results: In total, the data of 101 (female 50.5%) patients were included (76 patients with inactive HBV carriers and 25 patients with chronic HBV infection). The mean age of patients was 44±12 years, and the mean follow-up duration was 31±22 months. Of the 101 patients, 70 (69.3%) received antiviral treatment. HBV reactivation was detected in 13 of 76 (17.1%) patients with inactive HBV carriers. HBV reactivation was observed less frequently, not although significantly, in those patients receiving antiviral prophylaxis compared with those not receiving prophylaxis [5/41 (12.2%) vs. 8/33 (24.2%), p=0.17]. Forty-two patients (31 patients had inactive HBV carriers) were using anti-tumor necrosis factor agents. HBV reactivation was detected in 6 of the 31 (19.3%) patients. Twenty-five patients had chronic hepatitis, and five (20%) of them had not received antiviral prophylaxis. HBV viral loads were persistently elevated in 7 (28%) of 25 patients (three patients under and four patients not under antiviral treatment).

 

Conclusion: HBV reactivation was observed in approximately 17% of patients under immunosuppressive treatments. HBV reactivation was more frequently observed in those who did not receive antiviral prophylaxis. 

Key Words
Authors
All
Author’s Corner
Survey
AVES | Copyright © 2018 Medical Research and Education Association | Latest Update: 08.04.2019