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논문 기본 정보

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저자정보
Lan Ting-Yuan (Division of Rheumatology Department of Internal Medicine National Taiwan University Hospital Hsin-Chu Branch Hsinchu Taiwan) Lin Yen-Chun (Department of Internal Medicine National Taiwan University Hospital Yun-Lin Branch Douliu Taiwan) Tseng Tai-Chung (Division of Gastroenterology and Hepatology Department of Internal Medicine National Taiwan University Hospital Taipei TaiwanHepatitis Research Center National Taiwan University Hospital Taipei Taiwan) Yang Hung-Chih (Division of Gastroenterology and Hepatology Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan) Kao Jui-Hung (Department of Internal Medicine National Taiwan University Hospital Yun-Lin Branch Douliu Taiwan) Cheng Chiao-Feng (Department of Internal Medicine National Taiwan University Hospital Yun-Lin Branch Douliu Taiwan) Lee Tai-Ju (Division of Rheumatology Department of Internal Medicine National Taiwan University Taipei Taiwan) Huang Shang-Chin (Division of Gastroenterology Department of Internal Medicine National Taiwan University Hospital Bei-Hu Branch Taipei Taiwan) Lu Cheng-Hsun (Division of Rheumatology Department of Internal Medicine National Taiwan University Taipei Taiwan) Li Ko-Jen (Division of Rheumatology Department of Internal Medicine National Taiwan University Taipei Taiwan) Hsieh Song-Chou (Division of Rheumatology Department of Internal Medicine National Taiwan University Taipei Taiwan)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver 제17권 제2호
발행연도
2023.3
수록면
288 - 298 (11page)
DOI
10.5009/gnl210551

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Background/Aims: Rituximab is known to be associated with high hepatitis B virus (HBV) reactivation rate in patients with resolved HBV infection and hematologic malignancy. However, data regarding HBV reactivation (HBVr) in rheumatic patients receiving rituximab is limited. To assess the HBVr rate in hepatitis B surface antigen (HBsAg)-negative patients receiving rituximab for autoimmune diseases in a large real-world cohort. Methods: From March 2006 to December 2019, 900 patients with negative HBsAg receiving at least one cycle of rituximab for autoimmune diseases in a tertiary medical center in Taiwan were retrospectively reviewed. Clinical outcome and factors associated with HBVr were analyzed. Results: After a median follow-up period of 3.3 years, 21 patients developed HBVr, among whom 17 patients were positive for hepatitis B core antibody (anti-HBc) and four were negative. Thirteen patients had clinical hepatitis flare, while eight patients had HBsAg seroreversion without hepatitis. Old age, anti-HBc positivity, undetectable serum hepatitis B surface antibody level at rituximab initiation and a higher average rituximab dose were associated with a higher HBVr rate. There was no significant difference in the HBVr risk between rheumatoid arthritis and other autoimmune diseases. Among anti-HBc-negative patients, subjects without HBV vaccination at birth had an increased risk of HBVr (4/368, 1.1%) compared with those who received vaccination (0/126, 0%). Conclusions: In HBV endemic areas where occult HBV is prevalent, anti-HBc-negative patients, may still be at risk for HBVr after rituximab exposure. HBVr may still be considered in HBsAgnegative patients developing abnormal liver function after rituximab exposure, even in patients with negative anti-HBc.
#Hepatitis B #Autoimmune diseases #Rituximab

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