Hepatitis B reactivation in HBsAg-negative/HBcAb-positive patients receiving immunosuppressive therapy for glomerulonephritis: a retrospective analysis

Fang, Jing; Li, Wenge; Peng, Xiang-xin; Tan, Zhao; Tan, Min; Zhang, Cong; Wang, Wenbo; Xu, Zhijun; Zhou, Guangyuan

doi:10.1007/s11255-016-1487-5

Cited by 5 publications

(5 citation statements)

References 31 publications

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“…A total of 32 studies were identified evaluating immunosuppressing biologics and other disease-modifying antirheumatic drugs (DMARDs) for autoimmune diseases, which included rheumatoid arthritis, psoriasis, systemic lupus erythematosus, and aplastic anemia (Table 4). 67-98 TNFα inhibitors were the most common agents evaluated, and 6 studies included rituximab. Use of prophylaxis was rare.…”

Section: Resultsmentioning

confidence: 99%

Pharmacotherapy-Induced Hepatitis B Reactivation Among Patients With Prior Functional Cure: A Systematic Review

et al. 2018

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Section: Resultsmentioning

confidence: 99%

Pharmacotherapy-Induced Hepatitis B Reactivation Among Patients With Prior Functional Cure: A Systematic Review

et al. 2018

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“…HBsAg‐positive patients showed a higher rate of HBV reactivation than HBsAg‐negative patients . It has also been reported that negative or low HBsAb titer, immunosuppressive treatment duration of more than 1 year, combined immunosuppressants, advanced age and high‐dose corticosteroids even for short courses can be risk factors for HBV reactivation . Patients in a weak, immunosuppressed state for a long time or even those who have ceased immunosuppressive therapy are still at risk for HBV reactivation .…”

Section: Discussionmentioning

confidence: 98%

“…26 It has also been reported that negative or low HBsAb titer, immunosuppressive treatment duration of more than 1 year, combined immunosuppressants, advanced age and high-dose corticosteroids even for short courses can be risk factors for HBV reactivation. 8,11,27 Patients in a weak, immunosuppressed state for a long time or even those who have ceased immunosuppressive therapy are still at risk for HBV reactivation. 28 Therefore, a follow up of at least 12 months after the discontinuation of immunosuppression is recommneded.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of infectious diseases in patients with autoimmune blistering diseases

Ujiie

Yoshimoto

et al. 2020

The Journal of Dermatology

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A long‐term immunosuppressive treatment can provoke latent infections. Autoimmune blistering diseases (AIBD) are mostly treated with systemic immunosuppressive agents. To prevent the reactivation or exacerbation of existing latent infections, patients must be screened for infectious diseases before immunosuppressive treatments are initiated. However, the prevalence of infectious diseases in AIBD remains to be elucidated. To evaluate the necessity of screening infectious diseases in AIBD, we retrospectively reviewed the clinical records of 215 patients at a single center with AIBD for hepatitis B virus (HBV), hepatitis C virus (HCV), Mycobacterium tuberculosis, Treponema pallidum, human T‐cell leukemia virus type 1 (HTLV‐1) and HIV infections. Approximately 40% of patients were infected with HBV. During systemic corticosteroid treatment, HBV DNA became positive in 3.4% of cases. Antibodies to HCV, interferon‐γ release assays for M. tuberculosis and the T. pallidum latex agglutination test were positive in 0.6%, 6.6% and 1.2% cases, respectively. Neither HTLV‐1 nor HIV infections were detected. In conclusion, checks for HBV and M. tuberculosis infections should be made before immunosuppressive treatments are started, because of the high prevalence of these potentially life‐threatening infections. Other infections should be tested for depending on the patient’s risk factors.

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“…However, in HBsAg-negative/ HBcAb-positive patients with detectable serum HBV DNA, there were significant differences in liver function and coagulation function indexes in the immunosuppressive treatment group compared to the non-immunosuppressed group (P<0.05), suggesting that liver function was impaired. A retrospective analysis showed that the prevalence of HBV reactivation in patients receiving anti-TNFα therapy for glomerulonephritis was up to 3.62% in serological status of HBsAg-negative/HBcAb-positive (26), which demonstrated that when the immune system of the patient is suppressed by chemotherapy or immunosuppressive therapy, the hidden HBV virus in the body can become active again and begin to replicate, as manifested by an increase in the viral load detected by HBV DNA levels. Therefore, it is recommended that patients receiving immunosuppressive therapy or dialysis therapy should regularly monitor the serum HBV DNA levels if their serotype is HBsAgnegative/HBcAb-positive/HBeAb-positive (27,28).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical characteristics of hepatitis B surface antigen-negative/hepatitis B core antibody-positive patients with detectable serum hepatitis B virus DNA

Cai¹,

Wu²,

Wu³

et al. 2022

Ann Transl Med

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Background: To determine the prevalence of detectable serum hepatitis B virus (HBV) DNA in patients who are hepatitis B surface antigen (HBsAg)-negative and hepatitis B core antibody (HBcAb)-positive. The correlation between HBV DNA viral load and serological markers, as well as liver and coagulation function indicators were investigated. Furthermore, the effects of immunosuppressive therapy on DNA replication were assessed. Methods: A total of 2,013 HBsAg-negative/HBcAb-positive patients admitted to our hospital between January and December 2019 were enrolled in this study. Patient clinical characteristics including serological markers, HBV DNA viral load, liver function and coagulation function indicators, and immune function status were analyzed.Results: In the Hunan province in China, the prevalence of detectable HBV DNA was 5.4% in HBsAgnegative/HBcAb-positive patients. However, the prevalence of detectable HBV DNA in HBsAg-negative/ HBcAb-positive patients may vary because of different HBV serological markers. In patients with detectable serum HBV DNA, the log10 HBV DNA value was positively correlated with alanine transaminase (ALT) and aspartate transaminase (AST) levels, and negatively correlated with antithrombin III (AT III) concentrations.Moreover, in patients receiving immunosuppressive therapy, ALT and AST levels were higher than those of patients who did not receive immunosuppressive therapy. The ALT and AST levels in hepatitis B e antibody (HBeAb)-positive patients were significantly higher than that observed in HBeAb-negative patients.Conclusions: For HBsAg-negative/HBcAb-positive patients, clinicians should pay attention to the patient's immune function status. In situations where HBV DNA cannot be detected, changes in serum ALT, AST, and AT III concentrations can be used to speculate on viral replication status to reduce the risk of HBV infection and transmission.

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Hepatitis B reactivation in HBsAg-negative/HBcAb-positive patients receiving immunosuppressive therapy for glomerulonephritis: a retrospective analysis

Cited by 5 publications

References 31 publications

Pharmacotherapy-Induced Hepatitis B Reactivation Among Patients With Prior Functional Cure: A Systematic Review

Pharmacotherapy-Induced Hepatitis B Reactivation Among Patients With Prior Functional Cure: A Systematic Review

Prevalence of infectious diseases in patients with autoimmune blistering diseases

Prevalence and clinical characteristics of hepatitis B surface antigen-negative/hepatitis B core antibody-positive patients with detectable serum hepatitis B virus DNA

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