Hepatitis B Serology in Patients with Rheumatic Diseases

Overview

Journal Open Rheumatol J

Publisher Bentham Open

Specialty Rheumatology

Date 2016 Oct 7

PMID 27708728

Citations 10

Authors

Martin Feuchtenberger

Arne Schafer

Axel Philipp Nigg

Michael Rupert Kraus

Affiliations

Soon will be listed here.

Abstract

Background: Only limited data are available on the prevalence of hepatitis B in patients with proven rheumatic diseases and thus the risk of reactivation under immunosuppressive therapy.

Objective: To analyse hepatitis B serology in patients with rheumatic diseases prior to therapy.

Method: In total, 1,338 patient records were analysed for HBsAg, HBsAb and HBcAb in a cross-sectional, single-centre study between 2011 and 2015 at first presentation. Data acquisition was realized using electronic patient files created during routine care. The main variables considered as predictors for HBV reactivation included (i) the exact type of rheumatic disease and (ii) the therapeutically induced immunosuppression.

Results: Overall, 5.9% of patients (n=79) had proven contact with hepatitis B (HBcAb positive), and HBsAb were not detected in 1.3% (n=18). The rate of vaccinated subjects was 7.8%. HBsAg was detected in 3 patients (0.2%). In addition, 70.3% of patients were treated during the course of rheumatologic disease previously or currently with glucocorticoids, 85.2% with disease-modifying anti-rheumatic drugs (DMARDs) and 20.1% with a biologic agent ( , anti-IL-6, anti-TNFalpha, anti-CD20, CTLA4Ig or anti-IL-12/23).

Conclusion: Prevalence of hepatitis B serostatus in the analysed rheumatic patients regarding HBs-Ag and HBcAb with or without HBsAb prior to therapy does not differ from the data published for the general population in Germany. However, the rate of hepatitis B vaccinated patients was lower. In general, a significant portion of patients (5.9%) has been exposed to HBV and therefore exhibited an increased risk of reactivation of hepatitis B when undergoing immunosuppressive therapy.

Citing Articles

Detection of substantial numbers of latent tuberculosis and positive hepatitis B serology results in rheumatology patients preparing to receive intensified immunosuppressive therapy in a low-prevalence country: why screening still matters.

Feuchtenberger M, Kovacs M, Nigg A, Schafer A Clin Rheumatol. 2025; .

PMID: 39998600 DOI: 10.1007/s10067-025-07350-x.

Burden, Outcome, and Comorbidities of Extrahepatic Manifestations in Hepatitis B Virus Infections.

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Viral neuromyopathy associated with acute hepatitis B infection.

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Hepatitis B vaccination coverage in Germany: systematic review.

Steffen G, Sperle I, Harder T, Sarma N, Beermann S, Thamm R BMC Infect Dis. 2021; 21(1):817.

PMID: 34391406 PMC: 8364709. DOI: 10.1186/s12879-021-06400-4.

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

Canzoni M, Marignani M, Sorgi M, Begini P, Biondo M, Caporuscio S Microorganisms. 2020; 8(11).

PMID: 33207663 PMC: 7696870. DOI: 10.3390/microorganisms8111792.

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