The association between hepatitis B virus infection and disease activity, synovitis, or joint destruction in rheumatoid arthritis
The association between hepatitis B virus infection and disease activity, synovitis, or joint destruction in rheumatoid arthritis
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乙型肝炎病毒感染与类风湿关节炎疾病活动性、滑膜炎或关节破坏之间的关联
DOI：
10.1007/s10067-013-2170-1
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发表时间：
2013-06-01
影响因子：
3.4
通讯作者：
Dai, Lie
中科院分区：
文献类型：
--
作者：
Zou, Chan-Juan;Zhu, Lang-Jing;Dai, Lie
慢性B肝炎病毒（HBV）感染在中国的流行率很高。4%的HBV感染患者可出现多关节炎和类似于类风湿性关节炎（RA）的风湿因子阳性。在这里，我们调查了类风湿关节炎中HBV感染与血清学、放射学或组织学疾病状态之间的关系。根据HBV感染状况将223例RA患者分为慢性HBV感染组、既往HBV感染组和无HBV感染组。收集临床数据和手部X线照片。滑膜通过闭合针活检获得，连续组织切片进行HBV表面抗原（HBsAg）和分化簇（CD）标记物的免疫组织化学染色。(1)RA患者HBsAg阳性率和慢性B型肝炎患病率与中国正常人群一致（分别为11.2vs.8.7%，1.7vs.1.0%，P> 0.05）。(2)206例RA患者和140例初治患者的临床参数、28个关节的疾病活动性评分或Sharp评分在三组间无显著差异（均P> 0.05）。(3)10例HBV携带者和10例既往HBV感染者的滑膜免疫组化均为阴性。除既往HBV感染组内膜下CD 3+细胞密度较高外，RA患者的Krenn滑膜炎评分、内膜下阳性细胞（CD 20、CD 38、CD 79 a和CD 68）平均密度和CD 34+微血管计数在HBV携带者、既往HBV感染者和无HBV感染者之间均无显著性差异（均P> 0.05）。慢性HBV感染可能对RA的疾病活动性、滑膜炎或关节破坏无显著影响。
The prevalence of chronic hepatitis B virus (HBV) infection in China is high. Four percent of patients with HBV infection can present with polyarthritis and positive rheumatic factor similar to rheumatoid arthritis (RA). Here, we investigated the association between HBV infection and serological, radiological, or histological disease status in RA. According to HBV infection status, 223 consecutive hospitalized Chinese patients with RA were divided into the groups of chronic HBV infection, past HBV infection, and no HBV infection. Clinical data and hand radiographs were collected. Synovium was obtained by closed-needle biopsy, and serial tissue sections were stained immunohistochemically for HBV surface antigen (HBsAg) and cluster of differentiation (CD) markers. (1) The prevalence of HBsAg positivity and chronic hepatitis B in RA was consistent with the age-matched general Chinese population (11.2 vs. 8.7 %, 1.7 vs. 1.0 %, respectively,P> 0.05). (2) Clinical parameters, disease activity score in 28 joints, or Sharp scores showed no significant difference among the three groups in 206 RA or 140 treatment-naïve patients, both with active disease (allP> 0.05). (3) Synovial immunohistochemical staining showed negative HBsAg in ten RA patients with HBV carrier status and ten RA patients with past HBV infection. Except for higher subintimal CD3+ cell density in the past HBV infection group, Krenn’s synovitis score, mean densities of subintima positive-staining cells (CD20, CD38, CD79a, and CD68), and CD34+ microvessel counts showed no significant difference among RA patients with HBV carrier status, past HBV infection, or no HBV infection (allP> 0.05). Chronic HBV infection may have no significant effect on disease activity, synovitis, or joint destruction in RA.