Hepatitis B virus reactivation by immunosuppressive therapy in patients with autoimmune diseases: Risk analysis in hepatitis B surface antigen-negative cases

Masaru Kato*, Tatsuya Atsumi, Takashi Kurita, Toshio Odani, Yuichiro Fujieda, Kotaro Otomo, Tetsuya Horita, Shinsuke Yasuda, Takao Koike

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

47 被引用数 (Scopus)

抄録

Objective. To evaluate the risk of reactivation of resolved hepatitis B virus (HBV) by immunosuppressive therapy in patients with autoimmune diseases. Methods. Thirty-five patients with autoimmune diseases were included in our study; all were hepatitis B surface antigen (HBsAg)-negative and antibody against hepatitis B core antigen-positive. They were followed for 8-124 weeks and clinical outcomes were analyzed, including serum levels of HBV-DNA and aminotransferase every 4 weeks during their immunosuppressive therapy for underlying autoimmune diseases. If HBV-DNA was detected during the immunosuppressive therapy, HBsAg, antibody against HBsAg (anti-HBs), hepatitis B e antigen (HBeAg), and antibody against HBeAg were also monitored every 4 weeks. Results. HBV-DNA was detected in 6 out of 35 patients. Anti-HBs titer was significantly lower in the patients in whom HBV-DNA was detected compared with the others at baseline: 2.83 (range 0.24-168.50) mIU/ml vs 99.94 (range 0.00-5342.98) mIU/ml, respectively (p = 0.036). Outcomes of the 6 patients with HBV reactivation were as follows: HBV-DNA turned negative in 2 patients without nucleic acid analog (NAA) and 1 with NAA; 2 died due to bacterial sepsis; and 1 died due to autoimmune hemolytic anemia. Significant elevation of aminotransferase was found in only 1 patient, but HBsAg converted to positive in 2 patients and HBeAg converted to positive in 1 patient. Conclusion. Reactivation of resolved HBV can occur during standard immunosuppressive therapy for autoimmune diseases. The low titer of baseline anti-HBs may carry its risk. The Journal of Rheumatology

本文言語英語
ページ(範囲)2209-2214
ページ数6
ジャーナルJournal of Rheumatology
38
10
DOI
出版ステータス出版済み - 2011/10

ASJC Scopus 主題領域

  • リウマチ学
  • 免疫アレルギー学
  • 免疫学

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