Characteristics of patients with rheumatic diseases and chronic HBV infection treated with anti-TNF agents
| N | 14 |
| Sex (M/F) | 8/6 |
| Mean±SD (median) age (years) | 56±17 (53) |
| Underlying rheumatic disease | |
| Rheumatoid arthritis (RA) | 9 |
| Spondyloarthropathies | 5 |
| Psoriatic arthritis | 2 |
| Ankylosing spondylitis | 2 |
| Crohn-associated spondyloarthropathy | 1 |
| Mean (median) duration of rheumatic disease (years) | 8.8 (5.3) |
| Mean±SD (median) duration of follow-up during anti-TNF therapy (years) | 2.1±1.6 (1.9) |
| Type of anti-TNF therapy* | |
| Adalimumab | 6 |
| Etanercept | 6 |
| Infliximab | 5 |
| Concurrent antirheumatic treatment† | |
| Before anti-TNF therapy | |
| Steroids | 8 (57%) |
| DMARDs | 7 (50%) |
| During anti-TNF therapy | |
| Steroids | 2 (14%) |
| Status of chronic HBV infection | |
| DMARDs | 2 (14%) |
| Chronic hepatitis B | 6 (43%) |
| Inactive HBsAg carrier state | 8 (57%) |
| Liver biopsy | 8 (57%) |
| Grade of necroinflammation (HAI, 0–18) | 7.1±3.3 |
| Stage of fibrosis (0–6) | 2.7±1.0 |
| Antiviral therapy* | |
| Lamivudine | 11 |
| Entecavir | 3 |
| Tenofovir | 1 |
| Telbivudine | 1 |
Definitions of status of HBV infection: HBsAg inactive carrier: HBeAg−, ALT/AST: persistently normal, serum HBV DNA: <2000 IU/ml/10 000 copies/ml, liver biopsy: absence of significant necroinflammation or fibrosis (if performed).
Chronic hepatitis B: ALT/AST: persistently or intermittently elevated, HBV DNA: >2000 IU/10 000 copies/ml, liver biopsy: at least moderate necroinflammation or fibrosis (if performed).
↵* Since some patients were treated with two or three agents, the cumulative number exceeds 14.
↵† In the eight steroid-treated patients (seven with rheumatoid arthritis and one with ankylosing spondylitis), the mean treatment duration was 1.9 years (median 1.1 years) and the mean daily dose was 3.9 mg/day. Six patients (43%) reported occasional use of NSAIDs for pain control. DMARDs included methotrexate except in two patients who were switched to leflumomide.
ALT, alanine aminotransferase; AST, aspartate aminotransferase; DMARDs, disease-modifying antirheumatic drugs; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; NSAIDs, non-steroidal anti-inflammatory drugs.