title: Prevalence of hepatitis B virus infection in patients with rheumatic diseases in Tohoku area: a retrospective multicenter survey.
abstract: Hepatitis B virus (HBV) reactivation has been increasingly recognized in patients receiving chemotherapy and immunosuppressive therapy; however, the prevalence of HBV infection and rate of HBV screening in patients with rheumatic diseases remains unclear. In this study, we aimed to assess the prevalence of HBV infection and fulminant HBV hepatitis in patients with rheumatic diseases. We also investigated the rate of HBV screening before immunosuppressive therapy in patients with rheumatic diseases. A retrospective questionnaire survey was conducted in the North-east area (Tohoku) of Japan. Questionnaires, comprising 6 questions, were sent to 318 rheumatologists in May 2010, and responses were gathered until June 2011. In total, 71 rheumatologists (22.3%) responded to the survey. We enrolled 7,650 patients with rheumatoid arthritis (RA) and 1,031 patients with systemic lupus erythematosus (SLE). When limited to institutes at which almost all (≥ 90%) patients were tested for HBV serology, 1.1% (40/3,580) patients with RA and 0.3% (3/1,128) patients with SLE were positive for hepatitis B surface antigen (HBsAg), and 25.2% (177/703) patients with RA and 13.7% (34/248) patients with SLE were positive for hepatitis B core antibody (HBcAb). About one-third of rheumatologists did not check HBsAg and more than half did not check hepatitis B surface antibody (HBsAb) or HBcAb at all before therapy. Fulminant HBV hepatitis was observed in 1 RA patient who was current HBV carrier. In conclusion, the prevalence of HBV infection is high in patients with RA and SLE. HBV screening before immunosuppressive therapy should be strictly performed.
authors.affiliation: Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine.
authors.forename: Ryu
authors.initials: R
authors.lastname: Watanabe
authors.forename: Tomonori
authors.initials: T
authors.lastname: Ishii
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Ichizo
authors.initials: I
authors.lastname: Asahina
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Takemori
authors.forename: Tomomasa
authors.initials: T
authors.lastname: Izumiyama
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Oguchi
authors.forename: Yukitomo
authors.initials: Y
authors.lastname: Urata
authors.forename: Tomoe
authors.initials: T
authors.lastname: Nishimaki
authors.forename: Katsumi
authors.initials: K
authors.lastname: Chiba
authors.forename: Atsushi
authors.initials: A
authors.lastname: Komatsuda
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Chiba
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyata
authors.forename: Michiaki
authors.initials: M
authors.lastname: Takagi
authors.forename: Osamu
authors.initials: O
authors.lastname: Kawamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanno
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hirabayashi
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Konta
authors.forename: Yukari
authors.initials: Y
authors.lastname: Ninomiya
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Abe
authors.forename: Yuhji
authors.initials: Y
authors.lastname: Murata
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Saito
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
authors.forename: Hideo
authors.initials: H
authors.lastname: Harigae
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D015415:Biomarkers / Q000097:blood; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007564:Japan / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D008403:Mass Screening; D015995:Prevalence; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents