Mohsen Moghoofei1, Shayan Mostafaei2, Amir Ashraf-Ganjouei2, Hoda Kavosi3, Mahdi Mahmoudi4. 1. Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2. Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 3. Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: h-kavosi@tums.ac.ir. 4. Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: mahmoudim@tums.ac.ir.
Abstract
BACKGROUND: Hepatitis B is one of the most common infectious diseases worldwide. In patients undergoing immunosuppressive therapy such as rheumatic diseases, reactivation of hepatitis B virus (HBV) is considered clinically important. This systematic review and meta-analysis were performed to determine the prevalence rate of HBV reactivation in rheumatic patients from different parts of the world. METHODS: The authors performed a systematic literature review from several reliable databases including Scopus, ISI Web of Science and PubMed. Furthermore, the keywords of this research were "Hepatitis B virus", "Rheumatic diseases", "HBV reactivation", "Anti-TNF", "DMARDs" and "Biologic agents". RESULTS: The authors selected 30 studies out of 983 for the present review. The overall estimation of the prevalence of HBV reactivation was 1.4 (95% confidence interval (CI): 1.3-1.6). Also, the heterogeneity in estimating the pooled prevalence among the studies was shown; Cochran Q test, P < 0.001, I2 = 99.9%. It should be noted that max and min reactivation rate of HBV were in Italy and France respectively. CONCLUSIONS: Rheumatic disease patients with resolved hepatitis B should be tightly monitored for possible HBV reactivation by elevation of liver enzymes and HBV DNA levels.
BACKGROUND:Hepatitis B is one of the most common infectious diseases worldwide. In patients undergoing immunosuppressive therapy such as rheumatic diseases, reactivation of hepatitis B virus (HBV) is considered clinically important. This systematic review and meta-analysis were performed to determine the prevalence rate of HBV reactivation in rheumaticpatients from different parts of the world. METHODS: The authors performed a systematic literature review from several reliable databases including Scopus, ISI Web of Science and PubMed. Furthermore, the keywords of this research were "Hepatitis B virus", "Rheumatic diseases", "HBV reactivation", "Anti-TNF", "DMARDs" and "Biologic agents". RESULTS: The authors selected 30 studies out of 983 for the present review. The overall estimation of the prevalence of HBV reactivation was 1.4 (95% confidence interval (CI): 1.3-1.6). Also, the heterogeneity in estimating the pooled prevalence among the studies was shown; Cochran Q test, P < 0.001, I2 = 99.9%. It should be noted that max and min reactivation rate of HBV were in Italy and France respectively. CONCLUSIONS:Rheumatic diseasepatients with resolved hepatitis B should be tightly monitored for possible HBV reactivation by elevation of liver enzymes and HBV DNA levels.
Authors: Ilaria Lenci; Martina Milana; Giuseppe Grassi; Tommaso M Manzia; Carlo Gazia; Giuseppe Tisone; Roberta Angelico; Leonardo Baiocchi Journal: World J Gastroenterol Date: 2020-05-14 Impact factor: 5.742