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Incidence and risk factors for reactivation from resolved hepatitis B virus in rheumatoid arthritis patients treated with biological diseaseâmodifying antirheumatic drugs
- Source :
- International Journal of Rheumatic Diseases. 22:574-582
- Publication Year :
- 2018
- Publisher :
- Wiley, 2018.
-
Abstract
- To identify the incidence and risk factors for hepatitis B virus (HBV) reactivation in rheumatoid arthritis (RA) patients with resolved HBV receiving biological disease-modifying antirheumatic drugs (bDMARDs).Rheumatoid arthritis patients in whom bDMARD therapy was initiated in our departments from April 2009 to July 2016 were reviewed. The patients diagnosed with resolved HBV and whose HBV-DNA levels had been repeatedly measured were enrolled. The endpoint was HBV reactivation (a positive conversion of HBV-DNA or unquantifiable cases with positivity20 IU/mL). Nucleic acid analogues (NAAs) were administered when the HBV-DNA levels increased beyond 20 IU/mL. The associations between HBV reactivation and the clinical findings were retrospectively analyzed.One hundred and fifty-two RA patients with resolved HBV were enrolled; 133 (88%) patients had antibodies against HBV surface antigen (anti-HBs). The medicines that were administered included: abatacept (n = 29), golimumab (n = 26), etanercept (n = 25), tocilizumab (n = 25), adalimumab (n = 19), infliximab (n = 17) and certolizumab pegol (n = 11). During the observation period (15 [interquartile range 4.0-34] months), 7 (4.6%) patients developed HBV reactivation. In 5 of these patients, the HBV-DNA levels became negative or remained at20 IU/mL (+) without NAA therapy. HBV-DNA levels of20 IU/mL were observed in 2 patients but the HBV-DNA levels became negative after NAA treatment. Patients who were negative for anti-HBs showed a significantly higher incidence of HBV reactivation (P = 0.013).HBV reactivation occurred in 4.6% of RA patients with resolved HBV during the treatment with bDMARDs and the absence of anti-HBs may be a risk factor for the reactivation of resolved HBV.
- Subjects :
- Male
Hepatitis B virus
medicine.medical_specialty
medicine.disease_cause
Antiviral Agents
Gastroenterology
Etanercept
Arthritis, Rheumatoid
Immunocompromised Host
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Tocilizumab
Rheumatology
Risk Factors
Internal medicine
medicine
Adalimumab
Humans
030212 general & internal medicine
Hepatitis B Antibodies
Certolizumab pegol
Aged
Retrospective Studies
030203 arthritis & rheumatology
business.industry
Incidence
Abatacept
virus diseases
Middle Aged
Hepatitis B
medicine.disease
digestive system diseases
Infliximab
Treatment Outcome
chemistry
Antirheumatic Agents
Rheumatoid arthritis
DNA, Viral
Host-Pathogen Interactions
Female
Virus Activation
business
medicine.drug
Subjects
Details
- ISSN :
- 1756185X and 17561841
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- International Journal of Rheumatic Diseases
- Accession number :
- edsair.doi.dedup.....cfa2c2520d850c9eb2aaf7829aaf7884