Guideline Recommendations For Hepatitis Screening in Patients With Rheumatoid Arthritis

Hepatitis C virus
Hepatitis C virus
The guideline divides the participants into 5 groups according to HBV serology.

The Turkish Society of Rheumatology (TSR) has proposed a guideline of recommendations for hepatitis screening in patients with rheumatoid arthritis (RA) before performing biological therapy.

Researchers at the TSR used the Hacettepe University Rheumatology Biologic Registry (HUR-BIO) to assess results of viral hepatitis serological tests before biologics in patients with RA.

HUR-BIO is a prospective, single center database of biological treatments including 1229 patients with RA as of August 2016. Of the 1229 participants, 79.7% women, mean age was 54.9±11.7, and mean disease duration was 12.3±8.2 years.

The researchers evaluated serological test results from 468 patients with RA with hepatitis B virus (HBV). The guideline divides the participants into 5 groups according to HBV serology as follows:

  • Group 1: 273 HBV seronegative participants
  • Group 2: 81 vaccinated participants
  • Group 3: 19 participants with previous HBV infection
  • Group 4: 9 participants with chronic HBV infection
  • Group 5: 86 patients with secondary immunity

Participants were also classified by risk of HBV reactivation as:

  • Very high-risk: .4%, Group 4 patients receiving rituximab
  • High-risk: 4.7% Group 3 patients receiving rituximab
  • Medium-risk: 17.3% Groups 3 and 4 patients receiving TNFi or T-cell blockers, IL12/23 pathway inhibitor

The study also screened results for hepatitis C virus; 21 participants were anti-HCV positive.

The results of the study suggests that participants in the medium-risk group “deserve most of the attention,” according to the study abstract.1

“Screening for viral hepatitis must be performed before biologics and TSR guideline may be useful in this matter,” the researchers state.

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Sari A, Armagan B, Erden A, et al. Results of screening for viral hepatitis in RA patients treated with biologics: HUR-BIO real life results. Abstract AB0363. Presented at: Annual European Congress of Rheumatology. June 14-17, 2017; Madrid, Spain.