Prevalence of hepatitis B virus and hepatitis C virus infection in patients with systemic lupus erythematosus: a systematic review and meta-analysis

Abstract

We attempted to explore the prevalence of HBV and HCV infections in patients with systemic lupus erythematous (SLE) via a systematic review. Articles published before June 2017 and, related to prevalence rates for HBV and HCV infection in SLE patient were identified in PubMed, Embase, CNKI, and Wanfang databases. Based on these searches 22 studies were selected for further analysis. The OR of HBsAg positive rate in SLE patients compared with control population was 0.28, with significant heterogeneity identified among the studies (I2 = 92%, P < 0.00001). Following exclusion of one study, the adjusted OR of HBsAg in patients with SLE was 0.24, and no significant heterogeneity was observed (I2 = 32%, P = 0.15). The adjusted OR of HBcAb positive rate in SLE patients compared with control population was 0.40, with no significant heterogeneity between studies (I2 = 0%, P = 0.56). The risk of having HCV infection by SLE patients was higher compared with the control subjects (OR = 2.91). In conclusion, this meta-analysis suggested that SLE might exert a role of protection against HBV but not for HCV infection. Further epidemiological and experimental studies are necessary to explore the role and mechanisms by which SLE affects HBV/HCV infections.

Association between hepatitis C virus infection and subsequent chronic inflammatory skin disease

“…[34][35][36] While the relationship between HCV infection and lupus erythematosus is unclear, an increased prevalence of HCV infection in patients with systemic lupus erythematosus was reported. 37,38 De novo subacute cutaneous lupus erythematosus postantiviral treatment was described in two case reports, but a recent case report showed complete remission of discoid lupus erythematosus after initiation of antiviral treatment. [39][40][41] The role of antiviral treatment in these cutaneous manifestations is also intriguing.…”

Hepatic manifestations in systemic lupus erythematosus

“…72 , 73 A meta-analysis about the prevalence of HBV in patients with SLE has shown that this infection is less common in this population compared to healthy individuals. 74 These findings suggest a protective role of the immunological environment of SLE patients against HBV infection, although the exact mechanisms are still unclear. This is the main reason why screening for viral hepatitis and HIV has to be done before initiating any treatment with immunosuppressants.…”

Frequency of Hepatitis B Markers in Systemic Lupus Erythematosus Patients in Iran

“…Several studies have also reported low prevalence of HBV infection among SLE patients. Low prevalence of 2.7% HBV infection was observed in patients with SLE in China (Wang et al, 2017), 0.3% in Japan (Watanabe et al, 2014) and 1.5% (2/134) in Thailand (Sumethkul and Srivitidkul, 2017). Serological detection of "anti-HBc only" specifies exposure to HBV, lifelong persistence of cccDNA, and the risk for reactivation under strong immunosuppression (Gish et al, 2020).…”