Risk stratification and clinical course of hepatitis B virus reactivation in rheumatoid arthritis patients with resolved infection: final report of a multicenter prospective observational study at Japanese Red Cross Hospital
Identifieur interne : 000879 ( Main/Exploration ); précédent : 000878; suivant : 000880Risk stratification and clinical course of hepatitis B virus reactivation in rheumatoid arthritis patients with resolved infection: final report of a multicenter prospective observational study at Japanese Red Cross Hospital
Auteurs : Wataru Fukuda ; Tadamasa Hanyu ; Masaki Katayama ; Shinichi Mizuki ; Akitomo Okada ; Masayuki Miyata ; Yuichi Handa ; Masatoshi Hayashi ; Yoshinobu Koyama ; Kaoru Arii ; Toshiyuki Kitaori ; Hiroyuki Hagiyama ; Yoshinori Urushidani ; Takahito Yamasaki ; Yoshihiko Ikeno ; Takeshi Suzuki ; Atsushi Omoto ; Toshifumi Sugitani ; Satoshi Morita ; Shigeko InokumaSource :
- Arthritis Research & Therapy [ 1478-6354 ] ; 2019.
Abstract
The prophylaxis for hepatitis B virus (HBV) reactivation assumes that hepatic injury after reactivation is often rapidly progressive and can evoke fulminant hepatitis. The incidence and prognosis of reactivation in patients with rheumatoid arthritis (RA) may be different from those receiving organ transplantation and cancer chemotherapy. This study aimed to investigate the incidence, risk factors, and clinical course of HBV reactivation and develop a scoring system for risk stratification in RA patients with resolved infection.
HBV DNA was measured using real-time polymerase chain reaction, and patient data were collected for 4 years in RA patients with resolved HBV infection who were treated with steroids or synthetic or biologic immunosuppressive drugs.
Among 1127 patients, HBV DNA was detected in 57 patients (1.65/100 person-years); none of the reactivated patients exhibited worsening of hepatic function. Multivariate logistical analysis revealed that age > 70 years and HB core antibody (HBcAb) positivity alone were independent risk factors for HBV reactivation. HBV DNA ≥ 2.1 log copies/mL was observed in 15 patients (0.43/100 person-years); seven patients were treated with nucleic acid analogs (NAAs), whereas the remaining eight were observed without treatment. Among reactivated cases, 15 cases changed to HBV DNA-negative status spontaneously, whereas 24 cases remained HBV DNA positive < 2.1 log copies/mL during the observation period. We designed the following scoring system: HBV reactivation risk score = 1 × (age > 70 years) + 2 × (HBcAb positivity alone) + 1 × (treatment other than methotrexate monotherapy). This revealed that patients with the highest score had an odds ratio of 13.01 for HBV reactivation, compared to those with the lowest score.
Rapid progression and poor outcomes after HBV reactivation were not frequent in RA patients with resolved infection. Our new risk scoring system might be useful for screening and optimization of prophylactic treatment by distinguishing patients with significantly lower reactivation risk.
Url:
DOI: 10.1186/s13075-019-2053-1
PubMed: 31779676
PubMed Central: 6883521
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Risk stratification and clinical course of hepatitis B virus reactivation in rheumatoid arthritis patients with resolved infection: final report of a multicenter prospective observational study at Japanese Red Cross Hospital</title><author><name sortKey="Fukuda, Wataru" sort="Fukuda, Wataru" uniqKey="Fukuda W" first="Wataru" last="Fukuda">Wataru Fukuda</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1763 8262</institution-id><institution-id institution-id-type="GRID">grid.415604.2</institution-id><institution>Center for Rheumatic Disease,</institution><institution>Japanese Red Cross Kyoto Daiichi Hospital,</institution></institution-wrap>15-749 Honmachi, Higashiyama-ku, Kyoto City, Kyoto 605-0981 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 605-0981 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Hanyu, Tadamasa" sort="Hanyu, 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city, Fukushima 960-8530 Japan</nlm:aff><wicri:noCountry code="subfield">Fukushima 960-8530 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Handa, Yuichi" sort="Handa, Yuichi" uniqKey="Handa Y" first="Yuichi" last="Handa">Yuichi Handa</name><affiliation><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8733 7415</institution-id><institution-id institution-id-type="GRID">grid.416704.0</institution-id><institution>Department of Rheumatology,</institution><institution>Saitama Red Cross Hospital,</institution></institution-wrap>1-5 Shintoshin, Chuo-ku, Saitama city, Saitama 330-8553 Japan</nlm:aff><wicri:noCountry code="subfield">Saitama 330-8553 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Hayashi, Masatoshi" sort="Hayashi, Masatoshi" uniqKey="Hayashi M" first="Masatoshi" last="Hayashi">Masatoshi Hayashi</name><affiliation><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1764 9324</institution-id><institution-id institution-id-type="GRID">grid.416382.a</institution-id><institution>Department of Orthopedic Surgery and Rheumatology,</institution><institution>Nagano Red Cross Hospital,</institution></institution-wrap>5-22-1 Wakasato, Nagano city, Nagano 380-8582 Japan</nlm:aff><wicri:noCountry code="subfield">Nagano 380-8582 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Koyama, Yoshinobu" sort="Koyama, Yoshinobu" uniqKey="Koyama Y" first="Yoshinobu" last="Koyama">Yoshinobu Koyama</name><affiliation><nlm:aff id="Aff9"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1762 2623</institution-id><institution-id institution-id-type="GRID">grid.410775.0</institution-id><institution>Department of Rheumatology,</institution><institution>Japanese Red Cross Okayama Hospital,</institution></institution-wrap>2-1-1 Aoe, Kita-ku, Okayama city, Okayama 700-8607 Japan</nlm:aff><wicri:noCountry code="subfield">Okayama 700-8607 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Arii, Kaoru" sort="Arii, Kaoru" uniqKey="Arii K" first="Kaoru" last="Arii">Kaoru Arii</name><affiliation><nlm:aff id="Aff10"><institution-wrap><institution-id institution-id-type="GRID">grid.459719.7</institution-id><institution>Department of Internal Medicine,</institution><institution>Japanese Red Cross Kochi Hospital,</institution></institution-wrap>1-4-63-11 Hadaminamimachi, Kochi city, Kochi 780-8562 Japan</nlm:aff><wicri:noCountry code="subfield">Kochi 780-8562 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Kitaori, Toshiyuki" sort="Kitaori, Toshiyuki" uniqKey="Kitaori T" first="Toshiyuki" last="Kitaori">Toshiyuki Kitaori</name><affiliation><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1762 2623</institution-id><institution-id institution-id-type="GRID">grid.410775.0</institution-id><institution>Department of Orthopedic Surgery,</institution><institution>Japanese Red Cross Fukui Hospital,</institution></institution-wrap>2-4-1 Tsukimi, Fukui city, Fukui 918-8501 Japan</nlm:aff><wicri:noCountry code="subfield">Fukui 918-8501 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Hagiyama, Hiroyuki" sort="Hagiyama, Hiroyuki" uniqKey="Hagiyama H" first="Hiroyuki" last="Hagiyama">Hiroyuki Hagiyama</name><affiliation><nlm:aff id="Aff12">Department of Rheumatology, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama city, Kanagawa 231-8682 Japan</nlm:aff><wicri:noCountry code="subfield">Kanagawa 231-8682 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Urushidani, Yoshinori" sort="Urushidani, Yoshinori" uniqKey="Urushidani Y" first="Yoshinori" last="Urushidani">Yoshinori Urushidani</name><affiliation><nlm:aff id="Aff13"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1774 6503</institution-id><institution-id institution-id-type="GRID">grid.416587.9</institution-id><institution>Department of Rheumatology,</institution><institution>Matsue Red Cross Hospital,</institution></institution-wrap>200 Horomachi, Matsue city, Shimane 690-8506 Japan</nlm:aff><wicri:noCountry code="subfield">Shimane 690-8506 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Yamasaki, Takahito" sort="Yamasaki, Takahito" uniqKey="Yamasaki T" first="Takahito" last="Yamasaki">Takahito Yamasaki</name><affiliation><nlm:aff id="Aff14">Department of Orthopedic Surgery, Tanabe Chuo Hospital, 6-1-6 Tanabechuo, Kyotanabe city, Kyoto 610-0334 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 610-0334 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Ikeno, Yoshihiko" sort="Ikeno, Yoshihiko" uniqKey="Ikeno Y" first="Yoshihiko" last="Ikeno">Yoshihiko Ikeno</name><affiliation><nlm:aff id="Aff15">Department of Rheumatology, Nasu Red Cross Hospital, 1801-4 Nakadawara, Otawara city, Tochigi 324-0062 Japan</nlm:aff><wicri:noCountry code="subfield">Tochigi 324-0062 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Suzuki, Takeshi" sort="Suzuki, Takeshi" uniqKey="Suzuki T" first="Takeshi" last="Suzuki">Takeshi Suzuki</name><affiliation><nlm:aff id="Aff16"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1763 7921</institution-id><institution-id institution-id-type="GRID">grid.414929.3</institution-id><institution>Division of Allergy and Rheumatology,</institution><institution>Japanese Red Cross Medical Center,</institution></institution-wrap>4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935 Japan</nlm:aff><wicri:noCountry code="subfield">Tokyo 150-8935 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Omoto, Atsushi" sort="Omoto, Atsushi" uniqKey="Omoto A" first="Atsushi" last="Omoto">Atsushi Omoto</name><affiliation><nlm:aff 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Medicine,</institution></institution-wrap>Yoshidakonoe-cho, Sakyo-ku, Kyoto City, Kyoto 606-8501 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 606-8501 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Morita, Satoshi" sort="Morita, Satoshi" uniqKey="Morita S" first="Satoshi" last="Morita">Satoshi Morita</name><affiliation><nlm:aff id="Aff17"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0372 2033</institution-id><institution-id institution-id-type="GRID">grid.258799.8</institution-id><institution>Department of Biomedical Statistics and Bioinformatics,</institution><institution>Kyoto University Graduate School of Medicine,</institution></institution-wrap>Yoshidakonoe-cho, Sakyo-ku, Kyoto City, Kyoto 606-8501 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 606-8501 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Inokuma, Shigeko" sort="Inokuma, Shigeko" uniqKey="Inokuma S" first="Shigeko" last="Inokuma">Shigeko Inokuma</name><affiliation><nlm:aff id="Aff18">Department of Allergy and Rheumatology, Chiba Central Medical Center, 1835-1 Kasori-cho, Wakaba-ku, Chiba city, Chiba 264-0017 Japan</nlm:aff><wicri:noCountry code="subfield">Chiba 264-0017 Japan</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31779676</idno><idno type="pmc">6883521</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6883521</idno><idno type="RBID">PMC:6883521</idno><idno type="doi">10.1186/s13075-019-2053-1</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000214</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000214</idno><idno type="wicri:Area/Pmc/Curation">000214</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000214</idno><idno type="wicri:Area/Pmc/Checkpoint">000610</idno><idno type="wicri:explorRef" 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0004 1763 8262</institution-id><institution-id institution-id-type="GRID">grid.415604.2</institution-id><institution>Center for Rheumatic Disease,</institution><institution>Japanese Red Cross Kyoto Daiichi Hospital,</institution></institution-wrap>15-749 Honmachi, Higashiyama-ku, Kyoto City, Kyoto 605-0981 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 605-0981 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Hanyu, Tadamasa" sort="Hanyu, Tadamasa" uniqKey="Hanyu T" first="Tadamasa" last="Hanyu">Tadamasa Hanyu</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1774 7290</institution-id><institution-id institution-id-type="GRID">grid.416384.c</institution-id><institution>Department of Rheumatology,</institution><institution>Nagaoka Red Cross Hospital,</institution></institution-wrap>2-297-1 Senshu, Nagaoka-shi, Niigata 940-2085 Japan</nlm:aff><wicri:noCountry code="subfield">Niigata 940-2085 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Katayama, Masaki" sort="Katayama, Masaki" uniqKey="Katayama M" first="Masaki" last="Katayama">Masaki Katayama</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1764 7409</institution-id><institution-id institution-id-type="GRID">grid.417000.2</institution-id><institution>Department of Rheumatology,</institution><institution>Osaka Red Cross Hospital,</institution></institution-wrap>5-30 Fudegasaki-cho, Tennoji-ku, Osaka city, Osaka 543-8555 Japan</nlm:aff><wicri:noCountry code="subfield">Osaka 543-8555 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Mizuki, Shinichi" sort="Mizuki, Shinichi" uniqKey="Mizuki S" first="Shinichi" last="Mizuki">Shinichi Mizuki</name><affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1772 6975</institution-id><institution-id institution-id-type="GRID">grid.416592.d</institution-id><institution>The Center for Rheumatic Diseases,</institution><institution>Matsuyama Red Cross Hospital,</institution></institution-wrap>1 Bunkyo-cho, Matsuyama city, Ehime 790-8524 Japan</nlm:aff><wicri:noCountry code="subfield">Ehime 790-8524 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Okada, Akitomo" sort="Okada, Akitomo" uniqKey="Okada A" first="Akitomo" last="Okada">Akitomo Okada</name><affiliation><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1762 2623</institution-id><institution-id institution-id-type="GRID">grid.410775.0</institution-id><institution>Department of Rheumatology,</institution><institution>Japanese Red Cross Nagasaki Genbaku Hospital,</institution></institution-wrap>3-15 Mori-machi, Nagasaki city, Nagasaki 852-8511 Japan</nlm:aff><wicri:noCountry code="subfield">Nagasaki 852-8511 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Miyata, Masayuki" sort="Miyata, Masayuki" uniqKey="Miyata M" first="Masayuki" last="Miyata">Masayuki Miyata</name><affiliation><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1762 2623</institution-id><institution-id institution-id-type="GRID">grid.410775.0</institution-id><institution>Department of Internal Medicine,</institution><institution>Japanese Red Cross Fukushima Hospital,</institution></institution-wrap>7-7 Yashima-cho, Fukushima city, Fukushima 960-8530 Japan</nlm:aff><wicri:noCountry code="subfield">Fukushima 960-8530 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Handa, Yuichi" sort="Handa, Yuichi" uniqKey="Handa Y" first="Yuichi" last="Handa">Yuichi Handa</name><affiliation><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8733 7415</institution-id><institution-id institution-id-type="GRID">grid.416704.0</institution-id><institution>Department of Rheumatology,</institution><institution>Saitama Red Cross Hospital,</institution></institution-wrap>1-5 Shintoshin, Chuo-ku, Saitama city, Saitama 330-8553 Japan</nlm:aff><wicri:noCountry code="subfield">Saitama 330-8553 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Hayashi, Masatoshi" sort="Hayashi, Masatoshi" uniqKey="Hayashi M" first="Masatoshi" last="Hayashi">Masatoshi Hayashi</name><affiliation><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1764 9324</institution-id><institution-id institution-id-type="GRID">grid.416382.a</institution-id><institution>Department of Orthopedic Surgery and Rheumatology,</institution><institution>Nagano Red Cross Hospital,</institution></institution-wrap>5-22-1 Wakasato, Nagano city, Nagano 380-8582 Japan</nlm:aff><wicri:noCountry code="subfield">Nagano 380-8582 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Koyama, Yoshinobu" sort="Koyama, Yoshinobu" uniqKey="Koyama Y" first="Yoshinobu" last="Koyama">Yoshinobu Koyama</name><affiliation><nlm:aff id="Aff9"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1762 2623</institution-id><institution-id institution-id-type="GRID">grid.410775.0</institution-id><institution>Department of Rheumatology,</institution><institution>Japanese Red Cross Okayama Hospital,</institution></institution-wrap>2-1-1 Aoe, Kita-ku, Okayama city, Okayama 700-8607 Japan</nlm:aff><wicri:noCountry code="subfield">Okayama 700-8607 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Arii, Kaoru" sort="Arii, Kaoru" uniqKey="Arii K" first="Kaoru" last="Arii">Kaoru Arii</name><affiliation><nlm:aff id="Aff10"><institution-wrap><institution-id institution-id-type="GRID">grid.459719.7</institution-id><institution>Department of Internal Medicine,</institution><institution>Japanese Red Cross Kochi Hospital,</institution></institution-wrap>1-4-63-11 Hadaminamimachi, Kochi city, Kochi 780-8562 Japan</nlm:aff><wicri:noCountry code="subfield">Kochi 780-8562 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Kitaori, Toshiyuki" sort="Kitaori, Toshiyuki" uniqKey="Kitaori T" first="Toshiyuki" last="Kitaori">Toshiyuki Kitaori</name><affiliation><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1762 2623</institution-id><institution-id institution-id-type="GRID">grid.410775.0</institution-id><institution>Department of Orthopedic Surgery,</institution><institution>Japanese Red Cross Fukui Hospital,</institution></institution-wrap>2-4-1 Tsukimi, Fukui city, Fukui 918-8501 Japan</nlm:aff><wicri:noCountry code="subfield">Fukui 918-8501 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Hagiyama, Hiroyuki" sort="Hagiyama, Hiroyuki" uniqKey="Hagiyama H" first="Hiroyuki" last="Hagiyama">Hiroyuki Hagiyama</name><affiliation><nlm:aff id="Aff12">Department of Rheumatology, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama city, Kanagawa 231-8682 Japan</nlm:aff><wicri:noCountry code="subfield">Kanagawa 231-8682 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Urushidani, Yoshinori" sort="Urushidani, Yoshinori" uniqKey="Urushidani Y" first="Yoshinori" last="Urushidani">Yoshinori Urushidani</name><affiliation><nlm:aff id="Aff13"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1774 6503</institution-id><institution-id institution-id-type="GRID">grid.416587.9</institution-id><institution>Department of Rheumatology,</institution><institution>Matsue Red Cross Hospital,</institution></institution-wrap>200 Horomachi, Matsue city, Shimane 690-8506 Japan</nlm:aff><wicri:noCountry code="subfield">Shimane 690-8506 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Yamasaki, Takahito" sort="Yamasaki, Takahito" uniqKey="Yamasaki T" first="Takahito" last="Yamasaki">Takahito Yamasaki</name><affiliation><nlm:aff id="Aff14">Department of Orthopedic Surgery, Tanabe Chuo Hospital, 6-1-6 Tanabechuo, Kyotanabe city, Kyoto 610-0334 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 610-0334 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Ikeno, Yoshihiko" sort="Ikeno, Yoshihiko" uniqKey="Ikeno Y" first="Yoshihiko" last="Ikeno">Yoshihiko Ikeno</name><affiliation><nlm:aff id="Aff15">Department of Rheumatology, Nasu Red Cross Hospital, 1801-4 Nakadawara, Otawara city, Tochigi 324-0062 Japan</nlm:aff><wicri:noCountry code="subfield">Tochigi 324-0062 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Suzuki, Takeshi" sort="Suzuki, Takeshi" uniqKey="Suzuki T" first="Takeshi" last="Suzuki">Takeshi Suzuki</name><affiliation><nlm:aff id="Aff16"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1763 7921</institution-id><institution-id institution-id-type="GRID">grid.414929.3</institution-id><institution>Division of Allergy and Rheumatology,</institution><institution>Japanese Red Cross Medical Center,</institution></institution-wrap>4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935 Japan</nlm:aff><wicri:noCountry code="subfield">Tokyo 150-8935 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Omoto, Atsushi" sort="Omoto, Atsushi" uniqKey="Omoto A" first="Atsushi" last="Omoto">Atsushi Omoto</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1763 8262</institution-id><institution-id institution-id-type="GRID">grid.415604.2</institution-id><institution>Center for Rheumatic Disease,</institution><institution>Japanese Red Cross Kyoto Daiichi Hospital,</institution></institution-wrap>15-749 Honmachi, Higashiyama-ku, Kyoto City, Kyoto 605-0981 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 605-0981 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Sugitani, Toshifumi" sort="Sugitani, Toshifumi" uniqKey="Sugitani T" first="Toshifumi" last="Sugitani">Toshifumi Sugitani</name><affiliation><nlm:aff id="Aff17"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0372 2033</institution-id><institution-id institution-id-type="GRID">grid.258799.8</institution-id><institution>Department of Biomedical Statistics and Bioinformatics,</institution><institution>Kyoto University Graduate School of Medicine,</institution></institution-wrap>Yoshidakonoe-cho, Sakyo-ku, Kyoto City, Kyoto 606-8501 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 606-8501 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Morita, Satoshi" sort="Morita, Satoshi" uniqKey="Morita S" first="Satoshi" last="Morita">Satoshi Morita</name><affiliation><nlm:aff id="Aff17"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0372 2033</institution-id><institution-id institution-id-type="GRID">grid.258799.8</institution-id><institution>Department of Biomedical Statistics and Bioinformatics,</institution><institution>Kyoto University Graduate School of Medicine,</institution></institution-wrap>Yoshidakonoe-cho, Sakyo-ku, Kyoto City, Kyoto 606-8501 Japan</nlm:aff><wicri:noCountry code="subfield">Kyoto 606-8501 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Inokuma, Shigeko" sort="Inokuma, Shigeko" uniqKey="Inokuma S" first="Shigeko" last="Inokuma">Shigeko Inokuma</name><affiliation><nlm:aff id="Aff18">Department of Allergy and Rheumatology, Chiba Central Medical Center, 1835-1 Kasori-cho, Wakaba-ku, Chiba city, Chiba 264-0017 Japan</nlm:aff><wicri:noCountry code="subfield">Chiba 264-0017 Japan</wicri:noCountry></affiliation></author></analytic><series><title level="j">Arthritis Research & Therapy</title><idno type="ISSN">1478-6354</idno><idno type="eISSN">1478-6362</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">The prophylaxis for hepatitis B virus (HBV) reactivation assumes that hepatic injury after reactivation is often rapidly progressive and can evoke fulminant hepatitis. The incidence and prognosis of reactivation in patients with rheumatoid arthritis (RA) may be different from those receiving organ transplantation and cancer chemotherapy. This study aimed to investigate the incidence, risk factors, and clinical course of HBV reactivation and develop a scoring system for risk stratification in RA patients with resolved infection.</p></sec><sec><title>Methods</title><p id="Par2">HBV DNA was measured using real-time polymerase chain reaction, and patient data were collected for 4 years in RA patients with resolved HBV infection who were treated with steroids or synthetic or biologic immunosuppressive drugs.</p></sec><sec><title>Results</title><p id="Par3">Among 1127 patients, HBV DNA was detected in 57 patients (1.65/100 person-years); none of the reactivated patients exhibited worsening of hepatic function. Multivariate logistical analysis revealed that age > 70 years and HB core antibody (HBcAb) positivity alone were independent risk factors for HBV reactivation. HBV DNA ≥ 2.1 log copies/mL was observed in 15 patients (0.43/100 person-years); seven patients were treated with nucleic acid analogs (NAAs), whereas the remaining eight were observed without treatment. Among reactivated cases, 15 cases changed to HBV DNA-negative status spontaneously, whereas 24 cases remained HBV DNA positive < 2.1 log copies/mL during the observation period. We designed the following scoring system: HBV reactivation risk score = 1 × (age > 70 years) + 2 × (HBcAb positivity alone) + 1 × (treatment other than methotrexate monotherapy). This revealed that patients with the highest score had an odds ratio of 13.01 for HBV reactivation, compared to those with the lowest score.</p></sec><sec><title>Conclusions</title><p id="Par4">Rapid progression and poor outcomes after HBV reactivation were not frequent in RA patients with resolved infection. Our new risk scoring system might be useful for screening and optimization of prophylactic treatment by distinguishing patients with significantly lower reactivation risk.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Loomba, R" uniqKey="Loomba R">R Loomba</name></author><author><name sortKey="Liang, Tj" uniqKey="Liang T">TJ Liang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fukuda, W" uniqKey="Fukuda W">W Fukuda</name></author><author><name sortKey="Hanyu, T" uniqKey="Hanyu T">T Hanyu</name></author><author><name sortKey="Katayama, M" uniqKey="Katayama M">M Katayama</name></author><author><name sortKey="Mizuki, S" uniqKey="Mizuki S">S Mizuki</name></author><author><name sortKey="Okada, A" uniqKey="Okada A">A Okada</name></author><author><name sortKey="Miyata, M" uniqKey="Miyata M">M Miyata</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Oketani, M" uniqKey="Oketani M">M Oketani</name></author><author><name sortKey="Ido, A" uniqKey="Ido A">A Ido</name></author><author><name sortKey="Nakayama, N" uniqKey="Nakayama N">N Nakayama</name></author><author><name sortKey="Takikawa, Y" uniqKey="Takikawa Y">Y Takikawa</name></author><author><name sortKey="Naiki, T" uniqKey="Naiki T">T Naiki</name></author><author><name sortKey="Yamagishi, Y" uniqKey="Yamagishi Y">Y Yamagishi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Umemura, Takeji" uniqKey="Umemura T">Takeji Umemura</name></author><author><name sortKey="Tanaka, Eiji" uniqKey="Tanaka E">Eiji Tanaka</name></author><author><name sortKey="Kiyosawa, Kendo" uniqKey="Kiyosawa K">Kendo Kiyosawa</name></author><author><name sortKey="Kumada, Hiromitsu" uniqKey="Kumada H">Hiromitsu Kumada</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tsubouchi, H" uniqKey="Tsubouchi H">H Tsubouchi</name></author><author><name sortKey="Kumada, H" uniqKey="Kumada H">H Kumada</name></author><author><name sortKey="Kiyosawa, K" uniqKey="Kiyosawa K">K Kiyosawa</name></author><author><name sortKey="Mochida, S" uniqKey="Mochida S">S Mochida</name></author><author><name sortKey="Sakaid, I" uniqKey="Sakaid I">I Sakaid</name></author><author><name sortKey="Tanaka, E" uniqKey="Tanaka E">E Tanaka</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Harigai, M" uniqKey="Harigai M">M Harigai</name></author><author><name sortKey="Mochida, S" uniqKey="Mochida S">S Mochida</name></author><author><name sortKey="Mimura, T" uniqKey="Mimura T">T Mimura</name></author><author><name sortKey="Koike, T" uniqKey="Koike T">T Koike</name></author><author><name sortKey="Miyasaka, N" uniqKey="Miyasaka N">N Miyasaka</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Liaw, Yf" uniqKey="Liaw Y">YF 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uniqKey="Nagoshi S">S Nagoshi</name></author><author><name sortKey="Ido, A" uniqKey="Ido A">A Ido</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Prevoo, Ml" uniqKey="Prevoo M">ML Prevoo</name></author><author><name sortKey="Van Hof, Ma" uniqKey="Van Hof M">MA van’t Hof</name></author><author><name sortKey="Kuper, Hh" uniqKey="Kuper H">HH Kuper</name></author><author><name sortKey="Van Leeuwen, Ma" uniqKey="Van Leeuwen M">MA van Leeuwen</name></author><author><name sortKey="Van De Putte, Lb" uniqKey="Van De Putte L">LB van de Putte</name></author><author><name sortKey="Van Riel, Pl" uniqKey="Van Riel P">PL van Riel</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Tanaka, J" uniqKey="Tanaka J">J Tanaka</name></author><author><name sortKey="Kumagai, J" uniqKey="Kumagai J">J Kumagai</name></author><author><name sortKey="Katayama, K" uniqKey="Katayama K">K Katayama</name></author><author><name sortKey="Komiya, Y" uniqKey="Komiya Y">Y Komiya</name></author><author><name sortKey="Mizuki, M" uniqKey="Mizuki M">M Mizuki</name></author><author><name sortKey="Yamanaka, R" uniqKey="Yamanaka R">R Yamanaka</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fujita, M" uniqKey="Fujita M">M Fujita</name></author><author><name sortKey="Sugiyama, M" uniqKey="Sugiyama M">M Sugiyama</name></author><author><name sortKey="Sato, Y" uniqKey="Sato Y">Y Sato</name></author><author><name sortKey="Nagashima, K" uniqKey="Nagashima K">K Nagashima</name></author><author><name sortKey="Takahashi, S" uniqKey="Takahashi S">S Takahashi</name></author><author><name sortKey="Mizokami, M" uniqKey="Mizokami M">M Mizokami</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hayashi, K" uniqKey="Hayashi K">K Hayashi</name></author><author><name sortKey="Ishigami, M" uniqKey="Ishigami M">M Ishigami</name></author><author><name sortKey="Ishizu, Y" uniqKey="Ishizu Y">Y Ishizu</name></author><author><name sortKey="Kazuya, T" uniqKey="Kazuya T">T Kazuya</name></author><author><name sortKey="Honda, T" uniqKey="Honda T">T Honda</name></author><author><name sortKey="Hirooka, Y" uniqKey="Hirooka Y">Y Hirooka</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gwak, Gy" uniqKey="Gwak G">GY Gwak</name></author><author><name sortKey="Koh, Kc" uniqKey="Koh K">KC Koh</name></author><author><name sortKey="Kim, Hy" uniqKey="Kim H">HY Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ito, S" uniqKey="Ito S">S Ito</name></author><author><name sortKey="Nakazono, K" uniqKey="Nakazono K">K Nakazono</name></author><author><name sortKey="Murasawa, A" uniqKey="Murasawa A">A Murasawa</name></author><author><name sortKey="Mita, Y" uniqKey="Mita Y">Y Mita</name></author><author><name sortKey="Hata, K" uniqKey="Hata K">K Hata</name></author><author><name sortKey="Saito, N" uniqKey="Saito N">N Saito</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Velhelst, X" uniqKey="Velhelst X">X Velhelst</name></author><author><name sortKey="Orlent, H" uniqKey="Orlent H">H Orlent</name></author><author><name sortKey="Colle, I" uniqKey="Colle I">I Colle</name></author><author><name sortKey="Geerts, A" uniqKey="Geerts A">A Geerts</name></author><author><name sortKey="Vos, Md" uniqKey="Vos M">MD Vos</name></author><author><name sortKey="Vlierberghe, Hv" uniqKey="Vlierberghe H">HV Vlierberghe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, Yi Ming" uniqKey="Chen Y">Yi-Ming Chen</name></author><author><name sortKey="Yang, Sheng Shun" uniqKey="Yang S">Sheng-Shun Yang</name></author><author><name sortKey="Chen, Der Yuan" uniqKey="Chen D">Der-Yuan Chen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tien, Yc" uniqKey="Tien Y">YC Tien</name></author><author><name sortKey="Yen, Hh" uniqKey="Yen H">HH Yen</name></author><author><name sortKey="Chiu, Ym" uniqKey="Chiu Y">YM Chiu</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Arii, Kaoru" sort="Arii, Kaoru" uniqKey="Arii K" first="Kaoru" last="Arii">Kaoru Arii</name><name sortKey="Fukuda, Wataru" sort="Fukuda, Wataru" uniqKey="Fukuda W" first="Wataru" last="Fukuda">Wataru Fukuda</name><name sortKey="Hagiyama, Hiroyuki" sort="Hagiyama, Hiroyuki" uniqKey="Hagiyama H" first="Hiroyuki" last="Hagiyama">Hiroyuki Hagiyama</name><name sortKey="Handa, Yuichi" sort="Handa, Yuichi" uniqKey="Handa Y" first="Yuichi" last="Handa">Yuichi Handa</name><name sortKey="Hanyu, Tadamasa" sort="Hanyu, Tadamasa" uniqKey="Hanyu T" first="Tadamasa" last="Hanyu">Tadamasa Hanyu</name><name sortKey="Hayashi, Masatoshi" sort="Hayashi, Masatoshi" uniqKey="Hayashi M" first="Masatoshi" last="Hayashi">Masatoshi Hayashi</name><name sortKey="Ikeno, Yoshihiko" sort="Ikeno, Yoshihiko" uniqKey="Ikeno Y" first="Yoshihiko" last="Ikeno">Yoshihiko Ikeno</name><name sortKey="Inokuma, Shigeko" sort="Inokuma, Shigeko" uniqKey="Inokuma S" first="Shigeko" last="Inokuma">Shigeko Inokuma</name><name sortKey="Katayama, Masaki" sort="Katayama, Masaki" uniqKey="Katayama M" first="Masaki" last="Katayama">Masaki Katayama</name><name sortKey="Kitaori, Toshiyuki" sort="Kitaori, Toshiyuki" uniqKey="Kitaori T" first="Toshiyuki" last="Kitaori">Toshiyuki Kitaori</name><name sortKey="Koyama, Yoshinobu" sort="Koyama, Yoshinobu" uniqKey="Koyama Y" first="Yoshinobu" last="Koyama">Yoshinobu Koyama</name><name sortKey="Miyata, Masayuki" sort="Miyata, Masayuki" uniqKey="Miyata M" first="Masayuki" last="Miyata">Masayuki Miyata</name><name sortKey="Mizuki, Shinichi" sort="Mizuki, Shinichi" uniqKey="Mizuki S" first="Shinichi" last="Mizuki">Shinichi Mizuki</name><name sortKey="Morita, Satoshi" sort="Morita, Satoshi" uniqKey="Morita S" first="Satoshi" last="Morita">Satoshi Morita</name><name sortKey="Okada, Akitomo" sort="Okada, Akitomo" uniqKey="Okada A" first="Akitomo" last="Okada">Akitomo Okada</name><name sortKey="Omoto, Atsushi" sort="Omoto, Atsushi" uniqKey="Omoto A" first="Atsushi" last="Omoto">Atsushi Omoto</name><name sortKey="Sugitani, Toshifumi" sort="Sugitani, Toshifumi" uniqKey="Sugitani T" first="Toshifumi" last="Sugitani">Toshifumi Sugitani</name><name sortKey="Suzuki, Takeshi" sort="Suzuki, Takeshi" uniqKey="Suzuki T" first="Takeshi" last="Suzuki">Takeshi Suzuki</name><name sortKey="Urushidani, Yoshinori" sort="Urushidani, Yoshinori" uniqKey="Urushidani Y" first="Yoshinori" last="Urushidani">Yoshinori Urushidani</name><name sortKey="Yamasaki, Takahito" sort="Yamasaki, Takahito" uniqKey="Yamasaki T" first="Takahito" last="Yamasaki">Takahito Yamasaki</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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