title: Prevalence and time course of hepatitis B virus infection in patients with systemic lupus erythematosus under immunosuppressive therapy.
abstract: OBJECTIVE
  To clarify the prevalence and time course of hepatitis B virus (HBV) infection in patients with systemic lupus erythematosus under immunosuppressive therapy.
  
  
  METHODS
  We performed serological examination of 248 lupus patients to determine the presence of HBV, including hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc). Serum HBV DNA levels were measured in HBsAg-positive patients or resolved HBV carriers (HBsAg-negative, anti-HBs-positive, and/or anti-HBc-positive). If possible, we repeatedly performed examination of markers of HBV infection in resolved carriers.
  
  
  RESULTS
  Two (0.8%) patients were positive for HBsAg. Among 41 (16.5%) patients who were considered as resolved HBV carriers, 1 (2.4%) showed serum HBV DNA, which indicated occult HBV infection. The mean age and positive rate of anti-double stranded DNA antibody were significantly higher in resolved carriers than in anti-HBs- and anti-HBc-negative patients. Repeated examination showed that the anti-HBs and anti-HBc titer decreased below the threshold in 4 resolved carriers.
  
  
  CONCLUSIONS
  The prevalence of resolved HBV carriers in Japanese lupus patients was 16.5%. Among them, occult HBV infection and decrease in anti-HBs and anti-HBc titer were observed. These findings indicated that all lupus patients should undergo serological examination for HBV before treatment. If patients have already been treated, we must carefully monitor their liver function, even when all HBV markers are negative.
authors.affiliation: Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
authors.forename: Ryu
authors.initials: R
authors.lastname: Watanabe
authors.forename: Tomonori
authors.initials: T
authors.lastname: Ishii
authors.forename: Kyohei
authors.initials: K
authors.lastname: Nakamura
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shirai
authors.forename: Yumi
authors.initials: Y
authors.lastname: Tajima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujii
authors.forename: Hideo
authors.initials: H
authors.lastname: Harigae
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents