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地方流行区强直性脊柱炎患者在免疫抑制治疗期间乙型肝炎感染的挑战性管理

Challenging Management of Hepatitis B infection in Ankylosing Spondylitis Patients in an Endemic Area during Immunosuppressive Therapy.

作者信息

Nunes Gabriel Pacífico Seabra, Cunha Patrícia da Silva, Bosco Daniele Patrícia Dal, Ribeiro Sandra Lúcia Euzébio

机构信息

Departamento de Medicina, Universidade Nilton Lins, Manaus, AM, Brasil.

Departamento de Reumatologia, Hospital Universitário Getúlio Vargas, Manaus, AM, Brasil.

出版信息

Rev Soc Bras Med Trop. 2019 Mar 18;52:e20180386. doi: 10.1590/0037-8682-0386-2018.

DOI:10.1590/0037-8682-0386-2018
PMID:30892401
Abstract

Hepatitis B infection is a global health issue. When considering patients with rheumatic diseases, this is no different. By using immunosuppressant drugs, such as DMARDs and biologics, viral reactivation is possible, leading to serious consequences on the patient. We report 3 cases of association between ankylosing spondylitis and hepatitis B with the use of immunosuppressant drugs. Case 1 was a patient with previous HBV infection using DMARD. Cases 2 and 3 were patients chronically infected by HBV during immunosuppressant therapy. The management of HBV infection during immunosuppressant therapy is challenging and needs multidisciplinary support.

摘要

乙型肝炎感染是一个全球性的健康问题。在考虑患有风湿性疾病的患者时,情况也不例外。通过使用免疫抑制药物,如改善病情抗风湿药(DMARDs)和生物制剂,病毒再激活是有可能的,这会给患者带来严重后果。我们报告3例强直性脊柱炎与使用免疫抑制药物导致的乙型肝炎相关病例。病例1是一名曾感染乙肝病毒并使用DMARD的患者。病例2和病例3是在免疫抑制治疗期间慢性感染乙肝病毒的患者。免疫抑制治疗期间乙肝感染的管理具有挑战性,需要多学科支持。

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