Discontinuation of antiviral prophylaxis correlates with high prevalence of hepatitis B virus (HBV) reactivation in rheumatoid arthritis patients with HBV carrier state: a real-world clinical practice.
Discontinuation of antiviral prophylaxis correlates with high prevalence of hepatitis B virus (HBV) reactivation in rheumatoid arthritis patients with HBV carrier state: a real-world clinical practice.
复制标题
DOI：
10.1186/1471-2474-15-449
复制
发表时间：
2014-12-22
影响因子：
2.3
通讯作者：
Dai L
中科院分区：
文献类型：
--
作者：
Mo YQ;Liang AQ;Ma JD;Chen LF;Zheng DH;Schumacher HR;Dai L
目的探讨类风湿性关节炎(RA)患者在抗风湿药物(DMARDS)治疗和抗病毒预防的临床应用中，乙肝病毒(乙肝病毒)携带者再次激活的风险。包括连续的具有乙肝病毒携带者状态的RA患者。记录临床资料，包括肝脏评估、乙肝病毒感染评估和抗病毒预防的使用情况。对53例有乙肝病毒携带者状态的类风湿关节炎患者进行筛查，36例符合分析标准。36%的患者发生了乙肝病毒再激活，17%的患者同时发生了乙肝肝炎和再激活，其中一人发展为失代偿性肝硬变。只有50%的患者接受拉米夫定治疗，尽管所有患者都被推荐使用恩替卡韦或替诺福韦进行抗病毒预防，只有31%的患者在DMARDS治疗期间继续接受治疗。在停止抗病毒预防的患者中，有71%的患者在停止治疗21个月后出现乙肝病毒重新激活3 ~ 。Logistic回归分析显示，停药(OR：66，p = 0.027)、来氟米特(OR：，p = 0.011)和既往肝炎病史(OR：56，p = 0.013)是乙肝病毒再激活的危险因素。既往肝炎病史(OR：10，p = 0.021)也是乙肝复发的危险因素。我们的结果提示，在现实世界的临床实践中，对于中国乙肝病毒携带者状态的RA患者，患者接受和停止抗病毒预防的情况不应被忽视。在DMARDS治疗期间，停止抗病毒预防、既往肝炎病史和LEF可能会增加乙肝病毒携带者状态的RA患者乙肝病毒重新激活的风险。本文的在线版本(DOI：10.1186/1471-2474-15-449)包含补充材料，可供授权用户使用。
To investigate the risk of hepatitis B virus (HBV) reactivation in rheumatoid arthritis (RA) patients with HBV carrier state during treatment of disease-modifying antirheumatic drugs (DMARDs) and the use of antiviral prophylaxis in real-world clinical practice. Consecutive RA patients with HBV carrier state were included. Clinical data including liver evaluation, HBV infection evaluation and the use of antiviral prophylaxis were recorded. Fifty-three RA patients with HBV carrier state were screened and 36 patients were qualified for analysis. Thirty-six percentage of patients developed HBV reactivation and 17% developed HBV hepatitis together with reactivation, one of which developed decompensate cirrhosis. Only 50% of patients accepted lamivudine although all patients were recommended antiviral prophylaxis with entecavir or tenofovir and only 31% continued during DMARDs therapy. Seventy-one percentage of patients who discontinued antiviral prophylaxis developed HBV reactivation 3 ~ 21 months after discontinuation. Logistic regression analyses showed discontinuation of antiviral prophylaxis (OR: 66, p = 0.027), leflunomide (OR: 64, p = 0.011) and past history of hepatitis (OR: 56, p = 0.013) were risk factors of HBV reactivation. Past history of hepatitis (OR: 10, p = 0.021) was also risk factor of HBV hepatitis together with reactivation. Our results suggest poor patient acceptance and discontinuation of antiviral prophylaxis should not be ignored for Chinese RA patients with HBV carrier state in real-world clinical practice. Discontinuation of antiviral prophylaxis, past history of hepatitis and LEF might increase risk of HBV reactivation for RA patients with HBV carrier state during DMARDs therapy. The online version of this article (doi:10.1186/1471-2474-15-449) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
2.9
作者：
Malespin, Miguel;Wong, Shirley;Cotler, Scott J.
通讯作者：
Cotler, Scott J.
影响因子：
5.5
作者：
Emery, P;Breedveld, FC;Loew-Friedrich, I
通讯作者：
Loew-Friedrich, I
DOI：
10.1196/annals.1423.058
发表时间：
2007-01-01
期刊：
AUTOIMMUNITY, PT B: NOVEL APPLICATIONS OF BASIC RESEARCH
影响因子：
--
作者：
Galeazzi, Mauro;Bellisai, Francesca;Sebastiani, Gian Domenico
通讯作者：
Sebastiani, Gian Domenico
影响因子：
3.4
作者：
Tan, Jing;Zhou, Jingguo;Wei, Jing
通讯作者：
Wei, Jing
影响因子：
13.5
作者：
Tai, Dar-In;Lin, Shi-Ming;Liaw, Yun-Fan
通讯作者：
Liaw, Yun-Fan