Evaluation of hepatitis serology and frequency of viral reactivation in patients with inflammatory arthritis receiving biologic agents: a multicenter observational study
Özet
To evaluate of hepatitis serology and reactivation frequency in patients with rheumatic disease receiving biologic agents.
Our study included patients with infammatory rheumatic diseases from 23 centers, who were followed up with biological
therapy. Demographic and clinical characteristics of the patients, duration of drug use and hepatitis serology and the state
of viral reactivation were analyzed. A total of 4060 patients, 2095 being males, were included in our study. Of the patients,
2463 had Ankylosing Spondylitis (AS), 1154 had Rheumatoid Arthritis (RA), 325 had Psoriatic Arthritis (PsA), and 118 had
other infammatory rheumatic diseases. When the viral serology of the patients was evaluated, 79 patients (2%) who were
identifed as HBs Ag positive, 486 (12%) patients who were HBs Ag negative and anti-HBc IgG positive and 20 patients
(0.5%) who were anti-HCV positive. When evaluated on a disease-by-disease basis, the rate of HBsAg was found to be
2.5% in RA, 2% in AS and 0.9% in PsA. Viral reactivation was detected in 13 patients while receiving biologic agents. HBs
Ag was positive in nine patients with reactivation and negative in four patients. Anti-HBc IgG, however, was positive. Six
of these patients had AS, four had RA, and three had PsA. The development of hepatitis reactivation in 11.4% of HBs Ag
positive patients and 0.82% of anti-HBc IgG positive patients due to the use of biologic agents is an important problem for
this group of patients. Antiviral prophylaxis is recommended to be started especially in patients who are HBs Ag positive
and who are using biologic agents due to viral reactivation. Therefore, it is important to carry out hepatitis screenings before
biologic agent treatment and to carefully evaluate the vaccination and prophylaxis requirements.
