Follow-up of hepatitis reactivation in hepatitis B virus-infected patients with rheumatic diseases after different immunosuppressive therapy
10.3760/cma.j.issn.1007-7480.2015.04.011
- VernacularTitle:风湿性疾病合并乙型肝炎病毒感染12例不同免疫抑制治疗后病毒再激活的随访观察
- Author:
Yiqi YU
;
Dandan XUAN
;
Jiali WANG
;
Lingyun SHAO
;
Wenhong ZHANG
;
Hejian ZOU
- Publication Type:Journal Article
- Keywords:
Hepatitis B virus;
Rheumatic diseases;
Glucocorticoids;
Antirheumatic agents;
Tumor necrosis factor-alpha-blocking agent
- From:
Chinese Journal of Rheumatology
2015;19(4):261-266
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe hepatitis B virus (HBV) reactivation in 12 patients with rheumatic disease undergoing immunosuppressive therapy and to evaluate whether preemptive antiviral therapy is necessary for patients receiving disease-modifying anti-rheumatic drugs (DMARDs).Methods From January 2008 to March 2012,a total of 12 HBV-infected patients with rheumatic diseases were consecutively enrolled into this long-term follow-up study.Liver function and serum levels of HBV DNA were tested during the follow-up.Results The medium duration of follow-up was 41 months (range 16-48).Four patients received steroid treatment,and among them two patients without pre-emptive antiviral therapy developed HBV reactivation.After administr-ation of LAM or ETV,HBV replication was controlled in both patients.Five patients were treated with disease-modifying anti-rheumatic drugs and the other three patients received tumor necrosis factor-alpha-blocking agents.None of these patients received pre-emptive antiviral therapy.HBV reactivation did not occur in any of them.Conclusion HBV reactivation does occur in HBV-infected patients with rheumatoid diseases after immunosuppressive therapy.Pre-emptive antiviral therapy should be administered in patients who are receiving steroid therapy for rheumatic diseases.In contrast,DMARDs and TNFBA are relatively safe for HBV-infected patients with rheumatic diseases.Close monitoring of HBV DNA and ALT levels is necessary to the mana-gement of HBV reactivation.
