{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T11:29:21Z","timestamp":1786620561082,"version":"build-2736575974"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,28]],"date-time":"2019-11-28T00:00:00Z","timestamp":1574899200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,28]],"date-time":"2019-11-28T00:00:00Z","timestamp":1574899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>The prophylaxis for hepatitis B virus (HBV) reactivation assumes that hepatic injury after reactivation is often rapidly progressive and can evoke fulminant hepatitis. The incidence and prognosis of reactivation in patients with rheumatoid arthritis (RA) may be different from those receiving organ transplantation and cancer chemotherapy. This study aimed to investigate the incidence, risk factors, and clinical course of HBV reactivation and develop a scoring system for risk stratification in RA patients with resolved infection.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>HBV DNA was measured using real-time polymerase chain reaction, and patient data were collected for 4\u00a0years in RA patients with resolved HBV infection who were treated with steroids or synthetic or biologic immunosuppressive drugs.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Among 1127 patients, HBV DNA was detected in 57 patients (1.65\/100 person-years); none of the reactivated patients exhibited worsening of hepatic function. Multivariate logistical analysis revealed that age\u2009&gt;\u200970\u2009years and HB core antibody (HBcAb) positivity alone were independent risk factors for HBV reactivation. HBV DNA\u2009\u2265\u20092.1 log copies\/mL was observed in 15 patients (0.43\/100 person-years); seven patients were treated with nucleic acid analogs (NAAs), whereas the remaining eight were observed without treatment. Among reactivated cases, 15 cases changed to HBV DNA-negative status spontaneously, whereas 24 cases remained HBV DNA positive &lt;\u20092.1 log copies\/mL during the observation period. We designed the following scoring system: HBV reactivation risk score\u2009=\u20091\u2009\u00d7\u2009(age\u2009&gt;\u200970\u2009years)\u2009+\u20092\u2009\u00d7\u2009(HBcAb positivity alone)\u2009+\u20091\u2009\u00d7\u2009(treatment other than methotrexate monotherapy). This revealed that patients with the highest score had an odds ratio of 13.01 for HBV reactivation, compared to those with the lowest score.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Rapid progression and poor outcomes after HBV reactivation were not frequent in RA patients with resolved infection. Our new risk scoring system might be useful for screening and optimization of prophylactic treatment by distinguishing patients with significantly lower reactivation risk.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13075-019-2053-1","type":"journal-article","created":{"date-parts":[[2019,11,28]],"date-time":"2019-11-28T18:03:12Z","timestamp":1574964192000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Risk stratification and clinical course of hepatitis B virus reactivation in rheumatoid arthritis patients with resolved infection: final report of a multicenter prospective observational study at Japanese Red Cross Hospital"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3439-3565","authenticated-orcid":false,"given":"Wataru","family":"Fukuda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadamasa","family":"Hanyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Katayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Mizuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akitomo","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Miyata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Handa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Koyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Arii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Kitaori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Hagiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Urushidani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahito","family":"Yamasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Ikeno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Omoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Sugitani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeko","family":"Inokuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,28]]},"reference":[{"key":"2053_CR1","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1053\/j.gastro.2017.02.009","volume":"152","author":"R Loomba","year":"2017","unstructured":"Loomba R, Liang TJ. 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Ltd. (Ono), Takeda Pharmaceutical Co. Ltd. (Takeda), Daiichi-Sankyo Co. Ltd. (Daiichi-Sankyo), Astellas Pharm Inc. (Astellas), Mitsubishi-Tanabe Pharm (Mitsubishi-Tanabe), Pfizer Japan Inc. (Phizer), Asahi-Kasei Pharma (Asahi-Kasei), Janssen Pharmaceutical KK (Janssen), and Eli Lilly Japan K.K. (Eli Lilly) (less than $10,000 each). TH received speaking fees from AbbVie GK (AbbVie), Eli Lilly, Daiichi-Sankyo, Mitsubishi-Tanabe, Chugai Pharmaceutical Co. Ltd. (Chugai), and Ayumi Pharmaceutical Co. (Ayumi) (less than $10,000 each). SM received speaking fees from Ono, Daiichi-Sankyo, Astellas, Mitsubishi-Tanabe, Pfizer, Janssen, AbbVie, Chugai, and Eli Lilly (less than$10,000 each). MM received speaking fees from Chugai, AbbVie, Bristol-Myers Squibb Company (BMS), Eisai, Takeda, Janssen, Eli Lilly, Pfizer, and UCB Japan Co. Ltd. (UCB) (less than $10,000 each). YK received speaking fees from Ayumi, BMS, Chugai, Asahi-Kasei, and Eli Lilly (less than $10,000 each). TK received speaking fees from AbbVie, Asahi-Kasei, BMS, Chugai, and Mitsubishi-Tanabe (less than $10,000 each). HH received speaking fees from BMS, Chugai, Eizai, Daiichi-Sankyo, Astellas, Mitsubishi-Tanabe, Pfizer, Asahi-Kasei, Teijin Pharma Ltd., and GlaxoSmithKline KK (less than $10,000 each). YI received speaking fees from Asahi-Kasei (less than $1,000). TS received speaking fees from AbbVie, BMS, Chugai, UCB, Astellas, Mitsubishi-Tanabe, and Asahi-Kasei (less than $10,000 each). Atsushi Omoto received speaking fees from AbbVie, Chugai, Eizai, Ono, Takeda, Daiichi-Sankyo, Astellas, Mitsubishi-Tanabe, Pfizer, Asahi-Kasei, and Eli Lilly (less than $10,000 each). TS belonged to the affiliation stipulated, but by the time this manuscript had been developed, TS became an employee of Astellas. S.M. received honoraria from AstraZeneca K.K., BMS, Chugai, Eli Lilly, MSD K.K., Nippon Boehringer Ingelheim Co. Ltd., Ono, Pfizer, Kyowa Hakko Kirin, and Taiho Pharmaceutical Co. Ltd. MK, Akitimo Okada, YH, MH, KA, YU, TY, and SI declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"255"}}