The purpose of the study was to investigate the epidemiology and medical costs of systemic lupus erythematosus (SLE) in Taiwan. Cases of SLE were identified from the National Health Insurance Research Database with corresponding International Classification of Diseases, Ninth Revision (ICD-9) code 710.0 from January 2000 to December 2007. Age and sex-specific incidences were estimated by dividing the incidence number by population data obtained from the Department of Statistics, Ministry of the Interior. During the study period, 22,182 cases were identified. The average annual incidence rate was 8.1 per 100,000. The incidence was especially high in women of 20-54 years. The female:male incidence ratio increased with age to a peak in the age group of 40-44, and then declined. The prevalence increased steadily during the study period from 42.2/100,000 in 2000 to 67.4/100,000 in 2007, while the incidence decreased steadily from 9.9/100,000/year in 2001 to 6.8/100,000/year in 2007. The average cost was US$71.5 for each outpatient service and US$1922.3 for each hospitalization. This is the first epidemiologic study of both pediatric and adult SLE in Taiwan. The incidence and prevalence were higher than in most reports on Whites. The sex ratio was similar to that of Whites, with a marked female predominance, especially during reproductive age. There was a probable lower survival rate for male patients.

BackgroundOur aim was to investigate dynamic changes in hepatitis B virus (HBV) surface antibody (HBsAb) titer and the associated risk of HBV reactivation and clinical course in patients with HBV surface antigen negative/core antibody positive (HBsAg−/HBcAb+) serostatus during antirheumatic therapy with biologic agents.MethodsIn a prospective study from January 2013 to June 2017, we monitored the HBV serostatus of HBsAg−/HBcAb+ patients undergoing biologic therapy for rheumatic diseases. From HBsAb titers at baseline and subsequent time points, we calculated the person-years (PY) contributed by patients with different HBsAb levels: < 10 mIU/mL (negative); 10–100 mIU/mL (low); and > 100 mIU/mL (high). We analyzed the incidence of detectable HBV DNA and HBV reactivation in each group, and documented the clinical courses of patients.ResultsAmong 380 participants, 83 (21.8%) had baseline HBsAb < 10 mIU/mL, 156 (41.1%) HBsAb 10–100 mIU/mL, and 141 (37.1%) HBsAb > 100 mIU/mL. Total PY at study end were 169.3 PY from the HBsAb-negative group, 362.7 PY from the low-titer group, and 285.8 PY from the high-titer group. Seventeen patients had detectable HBV DNA, with respective incidence rates in negative, low- and high-titer groups of 4.7/100 PY, 2.5/100 PY, and 0/100 PY. Two HBsAb-negative patients subsequently developed HBV reactivation, an incidence of 1.2/100 PY.ConclusionsThe risk of HBV reactivation varied with HBsAb titer, which changed during biologic therapy. Neither HBV DNA nor reactivation were detected in patients with HBsAb > 100 mIU/mL, whereas HBV DNA without reactivation occurred periodically in patients with HBsAb 10–100 mIU/mL; HBsAb-negative serostatus was associated with a risk of HBV reactivation.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1748-z) contains supplementary material, which is available to authorized users.

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