HBV Serostatus in Patients with Rheumatic Diseases does not differ from General Population in Germany (A Single Center Study)
DOI:
https://doi.org/10.12970/2310-9874.2016.04.01.3Keywords:
antiHBc, antiHBs, HBsAg, HBV, immunosuppression, reactivationAbstract
Background: Only limited data are available on the prevalence of hepatitis B in patients with proven rheumatic diseases.
Objective: To analyse hepatitis B serology in patients with rheumatic diseases with special regard to the underlying disease and degree of immunosuppression.
Materials and Methodology: In total, 1,338 patient records were analysed for HBsAg, antiHBs and antiHBc in a cross-sectional, single-centre study between 2011 and 2015. 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 extent of therapeutically induced immunosuppression.
Results: Overall, 5.6% of patients (n=76) had proven contact with hepatitis B (antiHBc positive), and antiHBs were not detected in 1.3% (n=18). The rate of vaccinated subjects was 7.8%. Chronic hepatitis B was newly diagnosed 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 (e.g., 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 antiHBc with or without antiHBs 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, up to 1.3% (antiHBc +, antiHBs -) exhibited an increased risk of reactivation of hepatitis B when undergoing immunosuppressive therapy.
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