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Prevalence of Hepatitis B Virus Markers in Patients with Autoimmune Inflammatory Rheumatic Diseases in Italy

Authors :
Marco Canzoni
Massimo Marignani
Maria Laura Sorgi
Paola Begini
Michela Ileen Biondo
Sara Caporuscio
Vincenzo Colonna
Francesca Della Casa
Paola Conigliaro
Cinzia Marrese
Eleonora Celletti
Irene Modesto
Mario Stefano Peragallo
Bruno Laganà
Andrea Picchianti-Diamanti
Roberta Di Rosa
Claudia Ferlito
Simonetta Salemi
Raffaele D’Amelio
Tommaso Stroffolini
Source :
Microorganisms, Vol 8, Iss 11, p 1792 (2020)
Publication Year :
2020
Publisher :
MDPI AG, 2020.

Abstract

Chronic hepatitis B virus (HBV) infection may be reactivated by immunosuppressive drugs in patients with autoimmune inflammatory rheumatic diseases. This study evaluates HBV serum markers’ prevalence in rheumatic outpatients belonging to Spondyloarthritis, Chronic Arthritis and Connective Tissue Disease diagnostic groups in Italy. The study enrolled 302 subjects, sex ratio (M/F) 0.6, mean age ± standard deviation 57 ± 15 years, 167 (55%) of whom were candidates for immunosuppressive therapy. The Spondyloarthritis group included 146 subjects, Chronic Arthritis 75 and Connective Tissue Disease 83 (two patients had two rheumatic diseases; thus, the sum is 304 instead of 302). Ten subjects (3%) reported previous anti-HBV vaccination and tested positive for anti-HBs alone with a titer still protective (>10 IU/mL). Among the remaining 292 subjects, the prevalence of positivity for HBsAg, isolated anti-HBc, anti-HBc/anti-HBs, and any HBV marker was 2%, 4%, 18%, and 24%, respectively. A total of 26/302 (9%) patients with γ-globulin levels ≤0.7 g/dL were more frequently (p = 0.03455) prescribed immunosuppressive therapy, suggesting a more severe rheumatic disease. A not negligible percentage of rheumatic patients in Italy are at potential risk of HBV reactivation related to immunosuppressive therapy. Before starting treatment, subjects should be tested for HBV markers. Those resulting positive should receive treatment or prophylaxis with Nucleos (t) ides analogue (NUCs) at high barrier of resistance, or pre-emptive therapy, according to the pattern of positive markers. HB vaccination is recommended for those who were never exposed to the virus.

Details

Language :
English
ISSN :
20762607
Volume :
8
Issue :
11
Database :
Directory of Open Access Journals
Journal :
Microorganisms
Publication Type :
Academic Journal
Accession number :
edsdoj.488f953fd45741108fe7d82eb4f42639
Document Type :
article
Full Text :
https://doi.org/10.3390/microorganisms8111792