{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:39:41Z","timestamp":1787164781494,"version":"build-2736575974"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T00:00:00Z","timestamp":1581465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T00:00:00Z","timestamp":1581465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    To investigate the incidence and risk factors of hepatitis B virus (HBV) reactivation in HBV surface antigen (HBsAg)\n                    <jats:sup>\u2212<\/jats:sup>\n                    \/ HBV core antibody (HBcAb)\n                    <jats:sup>+<\/jats:sup>\n                    patients who underwent rituximab (RTX) therapy for rheumatoid arthritis (RA). From January 2000 through December 2017, a total of 134 RA patients with various HBV serostatuses who received RTX at Dalin Tzu Chi Hospital were screened. Finally, 50 HBsAg\n                    <jats:sup>\u2212<\/jats:sup>\n                    \/HBcAb\n                    <jats:sup>+<\/jats:sup>\n                    patients were enrolled in this retrospective study. Baseline characteristics, comedications, and the occurrence of HBV reactivation were recorded. Four HBsAg\n                    <jats:sup>\u2212<\/jats:sup>\n                    \/HBcAb\n                    <jats:sup>+<\/jats:sup>\n                    RA patients (8%; 4\/50) experienced HBV reactivation after treatment with RTX. Hepatitis flare-up occurred in 2 of these 4 patients, with a fatal outcome in one. HBV reactivation occurred approximately 1\u20134 years after the first dose of RTX and 0.5\u20131.5 years after the last one. In HBsAg\n                    <jats:sup>\u2212<\/jats:sup>\n                    \/HBcAb\n                    <jats:sup>+<\/jats:sup>\n                    patients, HBV reactivation was significantly more common in those who were HBV surface antibody (HBsAb)\n                    <jats:sup>\u2212<\/jats:sup>\n                    at baseline than in those who were HBsAb\n                    <jats:sup>+<\/jats:sup>\n                    (30% vs 4%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02). A history of adalimumab use was associated with HBV reactivation (100% vs 39%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02). A moderate risk of HBV reactivation was observed in HBsAg\n                    <jats:sup>\u2212<\/jats:sup>\n                    \/HBcAb\n                    <jats:sup>+<\/jats:sup>\n                    RA patients receiving RTX therapy. The reactivation may induce acute hepatitis and even death. To reduce the risk of HBV reactivation, regular monitoring of liver function is insufficient; monitoring of viral load and HBsAg or prophylaxis with antiviral therapy should be considered.\n                  <\/jats:p>","DOI":"10.1038\/s41598-020-59406-4","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T06:03:58Z","timestamp":1581487438000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Moderate Risk of Hepatitis B Virus Reactivation in HBsAg\u2212\/HBcAb+ Carriers Receiving Rituximab for Rheumatoid Arthritis"],"prefix":"10.1038","volume":"10","author":[{"given":"Meng Hsuan","family":"Kuo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6951-4646","authenticated-orcid":false,"given":"Chih-Wei","family":"Tseng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Hui","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Hsueh","family":"Tung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Chih","family":"Tseng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning-Sheng","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,12]]},"reference":[{"key":"59406_CR1","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1136\/annrheumdis-2016-210715","volume":"76","author":"JS Smolen","year":"2017","unstructured":"Smolen, J. S. et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 76, 960\u2013977, https:\/\/doi.org\/10.1136\/annrheumdis-2016-210715 (2017).","journal-title":"Ann Rheum Dis"},{"key":"59406_CR2","doi-asserted-by":"publisher","first-page":"e3","DOI":"10.1093\/rheumatology\/key208","volume":"58","author":"CR Holroyd","year":"2019","unstructured":"Holroyd, C. R. et al. The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis. Rheumatology (Oxford) 58, e3\u2013e42, https:\/\/doi.org\/10.1093\/rheumatology\/key208 (2019).","journal-title":"Rheumatology (Oxford)"},{"key":"59406_CR3","doi-asserted-by":"publisher","first-page":"92","DOI":"10.4103\/jpp.JPP_155_16","volume":"8","author":"ND Tank","year":"2017","unstructured":"Tank, N. D., Karelia, B. N. & Vegada, B. N. 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