The Tohoku Journal of Experimental Medicine
Online ISSN : 1349-3329
Print ISSN : 0040-8727
ISSN-L : 0040-8727
Regular Contribution
Prevalence of Hepatitis B Virus Infection in Patients with Rheumatic Diseases in Tohoku Area: A Retrospective Multicenter Survey
Ryu Watanabe, Tomonori Ishii, Hiroko Kobayashi, Ichizo Asahina, Hiromitsu Takemori, Tomomasa Izumiyama, Yoshito Oguchi, Yukitomo Urata, Tomoe Nishimaki, Katsumi Chiba, Atsushi Komatsuda, Noriyuki Chiba, Masayuki Miyata, Michiaki Takagi, Osamu Kawamura, Takashi Kanno, Yasuhiko Hirabayashi, Tsuneo Konta, Yukari Ninomiya, Yoshiyuki Abe, Yuhji Murata, Yoshihiro Saito, Hiromasa Ohira, Hideo Harigae, Takeshi Sasaki
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Keywords: hepatitis B virus, immunosuppressive therapy, rheumatoid arthritis, screening, systemic lupus erythematosus
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2014 Volume 233 Issue 2 Pages 129-133

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Abstract

Hepatitis B virus (HBV) reactivation has been increasingly recognized in patients receiving chemotherapy and immunosuppressive therapy; however, the prevalence of HBV infection and rate of HBV screening in patients with rheumatic diseases remains unclear. In this study, we aimed to assess the prevalence of HBV infection and fulminant HBV hepatitis in patients with rheumatic diseases. We also investigated the rate of HBV screening before immunosuppressive therapy in patients with rheumatic diseases. A retrospective questionnaire survey was conducted in the North-east area (Tohoku) of Japan. Questionnaires, comprising 6 questions, were sent to 318 rheumatologists in May 2010, and responses were gathered until June 2011. In total, 71 rheumatologists (22.3%) responded to the survey. We enrolled 7,650 patients with rheumatoid arthritis (RA) and 1,031 patients with systemic lupus erythematosus (SLE). When limited to institutes at which almost all (≥ 90%) patients were tested for HBV serology, 1.1% (40/3,580) patients with RA and 0.3% (3/1,128) patients with SLE were positive for hepatitis B surface antigen (HBsAg), and 25.2% (177/703) patients with RA and 13.7% (34/248) patients with SLE were positive for hepatitis B core antibody (HBcAb). About one-third of rheumatologists did not check HBsAg and more than half did not check hepatitis B surface antibody (HBsAb) or HBcAb at all before therapy. Fulminant HBV hepatitis was observed in 1 RA patient who was current HBV carrier. In conclusion, the prevalence of HBV infection is high in patients with RA and SLE. HBV screening before immunosuppressive therapy should be strictly performed.

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    The Tohoku Journal of Experimental Medicine (TJEM) was founded in 1920 by professors of Tohoku Imperial University, Medical School. The TJEM has been published continuously, except for the year of 1946 just after the World War II. The TJEM is open to original articles in all branches of medical sciences. The TJEM also covers the fields of disaster-prevention science, including earthquake archeology.

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