Ya-Chih Tien1, Hsu-Heng Yen2, Ying-Ming Chiu3. 1. Allergy, Immunology and Rheumatology Division, Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan. 2. Gastroenterology Division, Department of Internal Medicine, Changhua Christian Hospital, Changhua City; and General Education Center, Chienkuo Technology University, Changhua City, Taiwan. 3. Allergy, Immunology and Rheumatology Division, Department of Internal Medicine, Changhua Christian Hospital, Changhua City; and Department of Nursing, College of Medicine and Nursing, Hung Kuang University, Taichung City, Taiwan. 129273@cch.org.tw.
Abstract
OBJECTIVES: To analyse the incidence, clinical characteristics, and prognosis of patients with rheumatoid arthritis (RA) and hepatitis B virus (HBV) surface antigen negative/core antibody positive serostatus (HBsAg-/HBcAb+), who underwent rituximab therapy and developed HBV reactivation. METHODS: Medical records of RA patients with different HBV serostatus who received rituximab from January 2000 through January 2015 were reviewed. Case notes of four HBsAg-/HBcAb+ patients with RA who had HBV reactivation during treatment with rituximab were excerpted and summarised. We also searched the Medline (PubMed) database to identify published reports of other HBsAg-/HBcAb+ RA patients who likewise developed HBV reactivation during rituximab treatment. RESULTS: The study cohort comprised 54 RA patients who received rituximab, of whom 44 (81.5%) were HBsAg-/HBcAb+ whilst receiving rituximab. Four HBsAg-/HBcAb+ patients had HBV reactivations during rituximab therapy; thus, the incidence of HBV reactivation in the HBsAg-/HBcAb+ group was 9.1%. The literature search discovered another three cases, making a total of at least seven known rituximab-treated HBsAg-/HBcAb+ RA patients who have developed HBV reactivation. The mean duration from the first rituximab infusion to HBV reactivation was 25.4±4.6 months; no fatalities occurred. CONCLUSIONS: Approximately 9% of Taiwanese RA patients with HBsAg-/HBcAb+ serostatus had HBV reactivation around 2 years after starting regular rituximab therapy; they all had a relatively good prognosis.
OBJECTIVES: To analyse the incidence, clinical characteristics, and prognosis of patients with rheumatoid arthritis (RA) and hepatitis B virus (HBV) surface antigen negative/core antibody positive serostatus (HBsAg-/HBcAb+), who underwent rituximab therapy and developed HBV reactivation. METHODS: Medical records of RApatients with different HBV serostatus who received rituximab from January 2000 through January 2015 were reviewed. Case notes of four HBsAg-/HBcAb+ patients with RA who had HBV reactivation during treatment with rituximab were excerpted and summarised. We also searched the Medline (PubMed) database to identify published reports of other HBsAg-/HBcAb+ RApatients who likewise developed HBV reactivation during rituximab treatment. RESULTS: The study cohort comprised 54 RApatients who received rituximab, of whom 44 (81.5%) were HBsAg-/HBcAb+ whilst receiving rituximab. Four HBsAg-/HBcAb+ patients had HBV reactivations during rituximab therapy; thus, the incidence of HBV reactivation in the HBsAg-/HBcAb+ group was 9.1%. The literature search discovered another three cases, making a total of at least seven known rituximab-treated HBsAg-/HBcAb+ RApatients who have developed HBV reactivation. The mean duration from the first rituximab infusion to HBV reactivation was 25.4±4.6 months; no fatalities occurred. CONCLUSIONS: Approximately 9% of Taiwanese RApatients with HBsAg-/HBcAb+ serostatus had HBV reactivation around 2 years after starting regular rituximab therapy; they all had a relatively good prognosis.
Authors: Eva C Schwaneck; Manuel Krone; Sonja Kreissl-Kemmer; Benedikt Weißbrich; Johannes Weiss; Hans-Peter Tony; Ottar Gadeholt; Marc Schmalzing; Andreas Geier Journal: Clin Rheumatol Date: 2018-09-20 Impact factor: 2.980