caa a22 4500 445888792 CHVBK 20180317145608.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00535-010-0367-5 doi (NATIONALLICENCE)springer-10.1007/s00535-010-0367-5 Prospective study of reactivation of hepatitis B virus in patients with rheumatoid arthritis who received immunosuppressive therapy: evaluation of both HBsAg-positive and HBsAg-negative cohorts [Elektronische Daten] [Akihiro Tamori, Tatsuya Koike, Hitoshi Goto, Shigeyuki Wakitani, Masahiro Tada, Hiroyasu Morikawa, Masaru Enomoto, Masaaki Inaba, Tatsuya Nakatani, Masayuki Hino, Norifumi Kawada] Background: Screening and prophylactic treatment for hepatitis B virus (HBV) reactivation is recommended for patients who receive immunosuppressive or cytotoxic therapy. The aim of this study was to clarify the prevalence of HBV reactivation in rheumatoid arthritis (RA) patients who had received more than 1year of immunosuppressive therapy. This study also evaluated guidelines for determining HBV reactivation in patients with RA. Methods: This was a prospective non-randomized, non-controlled study. We enrolled 50 patients with RA who had antibodies against hepatitis B core antigen (anti-HBc) and who had started treatment with disease-modifying anti-rheumatic drugs, including those who had additionally received anti-tumor necrosis factor-α (anti-TNF-α). HBV DNA levels were measured every 2-3months by a real-time, polymerase chain reaction-based method. Entecavir was administered to patients with HBV DNA levels >2.1 log/ml. Results: The mean observation period was 23months (range 12-32months). HBV reactivation occurred in 2 of 5 patients with HBV surface antigen (HBsAg) and in 1 of 45 patients without HBsAg. In patients who received anti-TNF-α therapy, antibodies against HBsAg decreased significantly. Entecavir therapy inhibited HBV amplification and prevented HBV-associated flares of hepatitis. Conclusions: The incidence of HBV reactivation was low in RA patients in whom HBV infection had been resolved. Screening for HBV reactivation and prophylactic therapy with entecavir were effective means of preventing HBV-associated hepatic failure in patients with HBsAg, as well as in those with only anti-HBc who received immunosuppressive therapy for RA. Springer, 2011 Anti-tumor necrosis factor-α nationallicence Anti-HBs nationallicence Entecavir nationallicence HBV reactivation nationallicence Rheumatoid arthritis nationallicence ALT : Alanine aminotransferase nationallicence Anti-HBc : Antibodies against hepatitis B core antigen nationallicence Anti-HBs : Antibodies against HBsAg nationallicence Anti-TNF-α : Anti-tumor necrosis factor-α nationallicence DMARDs : Disease-modifying anti-rheumatic drugs nationallicence HBV : Hepatitis B virus nationallicence HBsAg : HBV surface antigen nationallicence MTX : Methotrexate nationallicence RA : Rheumatoid arthritis nationallicence Tamori Akihiro Department of Hepatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, 545-8585, Osaka, Japan aut Koike Tatsuya Department of Rheumatosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan aut Goto Hitoshi Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan aut Wakitani Shigeyuki Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan aut Tada Masahiro Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan aut Morikawa Hiroyasu Department of Hepatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, 545-8585, Osaka, Japan aut Enomoto Masaru Department of Hepatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, 545-8585, Osaka, Japan aut Inaba Masaaki Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan aut Nakatani Tatsuya Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan aut Hino Masayuki Department of Hematology, Osaka City University Graduate School of Medicine, Osaka, Japan aut Kawada Norifumi Department of Hepatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, 545-8585, Osaka, Japan aut Journal of Gastroenterology Springer Japan 46/4(2011-04-01), 556-564 0944-1174 46:4<556 2011 46 535 https://doi.org/10.1007/s00535-010-0367-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-010-0367-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tamori Akihiro Department of Hepatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Koike Tatsuya Department of Rheumatosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Goto Hitoshi Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Wakitani Shigeyuki Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Tada Masahiro Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Morikawa Hiroyasu Department of Hepatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Enomoto Masaru Department of Hepatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Inaba Masaaki Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Nakatani Tatsuya Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Hino Masayuki Department of Hematology, Osaka City University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Kawada Norifumi Department of Hepatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, 545-8585, Osaka, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/4(2011-04-01), 556-564 0944-1174 46:4<556 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer