Table 2

Characteristics of patients with rheumatic diseases and chronic HBV infection treated with anti-TNF agents

Sex (M/F)8/6
Mean±SD (median) age (years)56±17 (53)
Underlying rheumatic disease
 Rheumatoid arthritis (RA)9
  Psoriatic arthritis2
  Ankylosing spondylitis2
  Crohn-associated spondyloarthropathy1
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*
Concurrent antirheumatic treatment
 Before anti-TNF therapy
  Steroids8 (57%)
  DMARDs7 (50%)
 During anti-TNF therapy
  Steroids2 (14%)
Status of chronic HBV infection
  DMARDs2 (14%)
 Chronic hepatitis B6 (43%)
 Inactive HBsAg carrier state8 (57%)
Liver biopsy8 (57%)
 Grade of necroinflammation (HAI, 0–18)7.1±3.3
 Stage of fibrosis (0–6)2.7±1.0
Antiviral therapy*
  • 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.