Abstract:
:Clinical guidelines regarding anti-viral prophylaxis for HBV surface antigen (HBsAg) carriers starting anti-TNFα agents are not yet fully established, even in endemic regions of HBV infection. We retrospectively collected the clinical data of 52 HBsAg carriers with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) that had been administered anti-TNFα treatment at seven medical centers in South Korea. Periodic data of liver function tests and serum HBV DNA were both utilized to assess HBV reactivation. The YMDD motif mutation of HBV DNA polymerase was tested in lamivudine-treated patients with elevated HBV DNA. Three of the 52 patients were excluded from the analysis. Of the 49 analyzed patients, 20 patients received anti-viral prophylaxis (15 lamivudine, five entecavir) with anti-TNFα treatment. The remaining 29 patients were treated with anti-viral agents if needed at the discretion of the clinician and did not receive prophylaxis. Of the 29 patients who did not receive primary prophylaxis, two (6.9%) developed viral reactivation within a year of anti-TNFα treatment. In the prophylaxis group, one patient developed viral reactivation at week 64 of anti-TNFα therapy attributed to YMDD mutation caused by lamivudine. Patients with HBV reactivation all responded well to anti-viral therapy. In summary, anti-viral prophylaxis helped preventing HBV reactivation in HBsAg carriers with RA or AS starting anti-TNFα, yet mutation in the YMDD motif of HBV DNA polymerase could be detrimental to some patients under long-term lamivudine prophylaxis.
journal_name
Clin Rheumatoljournal_title
Clinical rheumatologyauthors
Ryu HH,Lee EY,Shin K,Choi IA,Lee YJ,Yoo B,Park MC,Park YB,Bae SC,Yoo WH,Kim SI,Lee EB,Song YWdoi
10.1007/s10067-012-1960-1subject
Has Abstractpub_date
2012-06-01 00:00:00pages
931-6issue
6eissn
0770-3198issn
1434-9949journal_volume
31pub_type
杂志文章abstract::This study was designed to investigate the functional heterogeneity of human Th17 and how their plasticity shapes the nature of immune cell responses to inflammation and autoimmune diseases, such as systemic lupus erythematosus (SLE). We evaluated functional Th17 cell subsets based on the profile of cytokine productio...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-011-1860-9
更新日期:2012-03-01 00:00:00
abstract::This cross-sectional investigation examined the prevalence and severity of dysphonia, globus pharyngeus, and dysphagia in patients affected by immunomediated (IM) diseases. Seventy subjects were administered the Voice Handicap Index (VHI) (scale 0-4), Glasgow-Edinburgh Throat Scale (GETS) (scale from 0 to 7) for globu...
journal_title:Clinical rheumatology
pub_type: 杂志文章
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journal_title:Clinical rheumatology
pub_type: 杂志文章,meta分析
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journal_title:Clinical rheumatology
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doi:10.1007/s10067-017-3890-4
更新日期:2018-02-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1007/s10067-008-0842-z
更新日期:2008-06-01 00:00:00
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journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-008-0884-2
更新日期:2008-09-01 00:00:00
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journal_title:Clinical rheumatology
pub_type: 信件
doi:10.1007/s10067-004-0953-0
更新日期:2005-02-01 00:00:00
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journal_title:Clinical rheumatology
pub_type: 杂志文章
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更新日期:2020-08-26 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2019-12-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2013-09-01 00:00:00
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更新日期:2013-05-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s100670050072
更新日期:1999-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:1990-12-01 00:00:00
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更新日期:1998-01-01 00:00:00
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pub_type: 杂志文章,meta分析
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pub_type: 已发布勘误
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pub_type: 杂志文章,多中心研究
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更新日期:2017-05-01 00:00:00
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journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF01451288
更新日期:1998-01-01 00:00:00