Multidisciplinary Approach to Prevent <i>de novo</i> Hepatitis B in Patients with Rheumatoid Arthritis
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- Watanabe Ryu
- Department of Rheumatology, Osaki Citizen Hospital Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine
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- Igarashi Takehiko
- Department of Gastroenterology, Osaki Citizen Hospital
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- Takahashi Taro
- Department of Hematology, Osaki Citizen Hospital
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- Kondo Hinako
- Department of Rheumatology, Osaki Citizen Hospital Department of Nephrology and Endocrinology, Osaki Citizen Hospital
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- Okazaki Soshi
- Department of Rheumatology, Osaki Citizen Hospital Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine
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- Kudo Masataka
- Department of Rheumatology, Osaki Citizen Hospital Department of Nephrology and Endocrinology, Osaki Citizen Hospital
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- Ohyanagi Masakazu
- Department of Clinical Laboratory, Osaki Citizen Hospital
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- Gamoh Makio
- Department of Medical Oncology, Osaki Citizen Hospital
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抄録
<p>The reactivation of hepatitis B virus (HBV) in patients with rheumatoid arthritis (RA) is currently a social problem. Our hospital has established a project team, which consisted of medical staff including doctors, nurses, pharmacists, and technicians, to prevent HBV reactivation and subsequent de novo hepatitis B in 2015. To verify the usefulness of the team, we aimed to examine the implementation rate of HBV screening tests in patients with RA in 2011, 2015, and 2018. We also examined the rate of HBV infection, as well as the rate of HBV reactivation during the course. In this study, medical records of patients who visited our hospital in 2011, 2015, and 2018 were retrospectively reviewed. HBV screening was completed when hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), and hepatitis B core antibody (HBcAb) were all examined. The prevalence of patients who completed HBV screening dramatically increased from 2.4% in 2011 to 79.1% in 2015 and 86.9% in 2018. Patients who completed the screening had significantly higher rates of liver dysfunction, methotrexate use, and use of biological disease-modifying antirheumatic drugs than those who did not. Of the 767 patients who completed HBV screening in 2018, 157 patients (20.5%) had previously resolved HBV infection (HBsAg-negative but HBsAb- and/or HBcAb-positive). During a mean follow-up of 41.0 months, reactivation of HBV was observed in 10 out of the 157 patients (6.4%); however, none developed de novo hepatitis B. In conclusion, our multidisciplinary approach to prevent de novo hepatitis B is considered useful.</p>
収録刊行物
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- The Tohoku Journal of Experimental Medicine
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The Tohoku Journal of Experimental Medicine 252 (2), 133-141, 2020
東北ジャーナル刊行会