HBV reactivation in rheumatic diseases patients under therapy: A meta-analysis. (January 2018)

• Record Type: Journal Article
• Authors: Moghoofei, Mohsen; Mostafaei, Shayan; Ashraf-Ganjouei, Amir; Kavosi, Hoda; Mahmoudi, Mahdi
• Is Part Of: Microbial pathogenesis. Volume 114(2018)
• Page Start: 436
• Page End: 443
• Publication Date: 2018-01
• Subjects: HBV reactivation -- Rheumatic disease -- Meta-analysis; Pathogenic microorganisms -- Periodicals; Pathology, Molecular -- Periodicals; Communicable Diseases -- microbiology -- Periodicals; Communicable Diseases -- parasitology -- Periodicals; Micro-organismes pathogènes -- Périodiques; Pathologie moléculaire -- Périodiques; Electronic journals; 616.9041
• DOI: 10.1016/j.micpath.2017.12.014
• Languages: English
• ISSNs: 0882-4010

Abstract

Abstract: Background: Hepatitis B is one of the most common infectious diseases worldwide. In patients undergoing immunosuppressive therapy such as rheumatic diseases, reactivation of hepatitis B virus (HBV) is considered clinically important. This systematic review and meta-analysis were performed to determine the prevalence rate of HBV reactivation in rheumatic patients from different parts of the world. Methods: The authors performed a systematic literature review from several reliable databases including Scopus, ISI Web of Science and PubMed. Furthermore, the keywords of this research were "Hepatitis B virus", "Rheumatic diseases", "HBV reactivation", "Anti-TNF", "DMARDs" and "Biologic agents". Results: The authors selected 30 studies out of 983 for the present review. The overall estimation of the prevalence of HBV reactivation was 1.4 (95% confidence interval (CI): 1.3–1.6). Also, the heterogeneity in estimating the pooled prevalence among the studies was shown; Cochran Q test, P < 0.001, I 2 = 99.9%. It should be noted that max and min reactivation rate of HBV were in Italy and France respectively. Conclusions: Rheumatic disease patients with resolved hepatitis B should be tightly monitored for possible HBV reactivation by elevation of liver enzymes and HBV DNA levels. Highlights: Hepatitis B is one of the most common infectious diseases worldwide. In patients with rheumatic diseases undergoing immunosuppressive therapy, reactivation of HBV is considered clinically important. Rheumatic patients with resolved hepatitis B should be monitored for possible HBV reactivation by measuring liver enzymes and HBV DNA levels.