Background Reactivation of HBV infection is a serious problem in the setting of immunosuppression.
Objectives This prospective study was designed to determine the prevalence of anti-HBc and HBsAg among consecutive patients with different rheumatic diseases referred to an outpatient rheumatology clinic in Italy between December 2011 and January 2014.
Methods We enrolled 540 patients (394 female; mean age 55±14.2 yrs) with various rheumatic diseases. All were tested for anti-HBc as well as for HBsAg and HBV-DNA if anti-HBc positive.
Results Among the 540 patients, anti-HBc was detected in 101/540 (19%). HBsAg was positive in 8/540 (1.5%) with a positive HBV-DNA in 2 patients (330 and 9.092 UI/ml, respectively), not detected in 4 and not available in the other two. Prevalence of anti-HBc was significantly higher in males 37/146 vs 64/394 in females; p=0.018. Non-Italians showed higher prevalence of anti-HBc compared to Italians (23/99 vs 76/441 respectively, p=0.202). 16/101 (16%) anti-HBc-positive patients have received biological treatment (alone or in association with disease-modifying antirheumatic drugs) ± steroids for an average of 7.5 years but none developed HBV reactivation. The prevalence of anti-HBc in different rheumatic diseases is analyzed in the table 1.
Conclusions About one fifth of rheumatic patients are anti-HBc positive which showed higher prevalence in males. Screening for a resolved or active HBV infection is mandatory for all patients with rheumatic diseases especially if candidates for an immunosuppressive therapy. The potential risk of HBV reactivation in such setting is low.
Disclosure of Interest : None declared