Prevalence of Hepatitis B Serology and Reactivation in Rheumatology Patients Receiving Biologic or Targeted Synthetic Disease-Modifying Antirheumatic Drugs

Aim: This study sought to assess hepatitis B virus (HBV) serology and the incidence of HBV reactivation (HBVr) in rheumatology patients with resolved hepatitis B infection (HBsAg negative and HBcAb positive) who were undergoing treatment with biologic or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). Material and Method: Data from rheumatology patients treated with b/tsDMARDs were retrospectively reviewed from the electronic records. The demographic data, the anti-rheumatic drugs used, and the hepatitis serologies (HBsAg, anti-HBc IgG, anti-HBs, and anti-HCV) of the patients were analyzed. Results: The study included a total of 316 patients, of whom 217 (68.7%) were diagnosed with ankylosing spondylitis, 74 (23.4%) with rheumatoid arthritis, and 25 (7.9%) with psoriatic arthritis. Evaluation of the patients' viral serologies revealed that four (1.2%) were HBsAg positive, and 18 (5.7%) were HBsAg negative and HBcAb positive. Anti-HCV positivity was observed in one (0.3%) patient. All serologies were negative in 153 (48.4%) patients. No HBVr was detected during the follow-up of the patients. Conclusion: The rate of resolved hepatitis B infection is relatively high in patients under rheumatologic follow-up. However, the use of biologics in these patients poses a low risk of HBVr.