[To the problem of extended serological testing for viral hepatitis B in rheumatoid arthritis patients].

AIM: The objectives of the study: to conduct serologic screening for latent HBV infection in rheumatoid arthritis (RA) patients, to determine the level of protective antibodies to HBsAg in RA patients, and to determine the clinical and laboratory features of RA patients with latent hepatitis B in the course of retrospective analysis.

MATERIALS AND

METHODS

440 HBsAg-negative RA patients over 18 years old were included in the study. Blood serum was analyzed for the presence of antibodies to HBcAg (anti-HBc) by semi-quantitative method and the content of antibodies to HBsAg by quantitative method. Patients were included in the study consecutively, the inclusion criterion was negative HBsAg test, the exclusion criteria were co-infection with hepatitis C virus or HIV.

RESULTS

It was found that 64 (14%) patients were anti-HBs positive, in this group more than half [39 (61%)] had no antibodies to HBsAg (anti-HBs) in protective titer (more than 10 IU/mL), and 26 patients had no anti-HBs at all. Overall, only 130 (30%) patients in the cohort had anti-HBs in protective titer. Retrospective analysis of case histories and outpatient records revealed 33 cases of transaminase elevation, and in 15 patients this adverse event was the cause of antirheumatic drug withdrawal. Clinically significant thrombocytopenia occurred in 10 patients.

CONCLUSION

Extended HBV screening for RA patients showed the absence of anti-HBV protection in 70% of patients. Latent HBV [HBsAg(-)/anti-HBc(+)] was detected in 14% of patients. It is necessary to be alert to cases of combined elevation of ALT and/or AST and thrombocytopenia as symptoms of probable exacerbation of HBV infection.