Ye Junna, Xie Peilin, Zhou Zhuochao, Sun Yue, Wang Fan, You Yijun, Teng Jialin, Yang Chengde, Zhang Xinxin, Han Yue
Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Infectious Diseases, Research Laboratory of Clinical Virology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Med (Lausanne). 2022 Feb 10;9:814423. doi: 10.3389/fmed.2022.814423. eCollection 2022.
By determining the hepatitis B virus (HBV) surface antigen (HBsAg) positive rate postexposure and HBV-specific antigen/antibody (Ag/Ab) level in patients with rheumatic diseases, we aimed at exploring the rheumatic link to HBV control.
Patients who underwent HBV screening in the Ruijin Hospital from 2020 to 2021 were enrolled for the exposure rate estimation. Among antibody to HBV core antigen (HBcAb)-positive patients, we adopted propensity score matching (PSM) to study the impact of rheumatism on HBsAg seroprevalence after exposure. A second PSM evaluated the Ag/Ab differences. We also had HBsAg prevalence in human leukocyte antigen B2 (HLA-B27) tested patients studied.
With 33,989 screened patients, exposure rates remained comparable between rheumatic and non-rheumatic patients: 48.94 vs. 49.86%. PSM first yielded 2,618 balanced pairs. We observed significantly fewer patients with rheumatic diseases in HBsAg positive cases than negative ones ( < 0.001). In the second round, PSM matched 279 pairs, HBsAg ( < 0.001) and HBeAg ( < 0.05) positivity rates were significantly lower in the rheumatic patients, whereas HBsAb positivity rate ( < 0.001) and level ( < 0.01) were significantly higher. Though the value of HBcAb was overall significantly lower ( < 0.001) within the realm of rheumatic diseases, patients with ankylosing spondylitis (AS) demonstrated a significantly higher value than other rheumatic diseases. We saw significantly fewer HBV infections in HLA-B27 positive subjects than in the negative ones ( < 0.001).
In this propensity score-matched study, rheumatic patients had an advantage in HBV control. In rheumatic patients, HBcAb levels, together with the beneficial role of HLA-B27, were highlighted.
通过测定风湿性疾病患者暴露后乙肝病毒（HBV）表面抗原（HBsAg）阳性率及HBV特异性抗原/抗体（Ag/Ab）水平，旨在探索风湿性疾病与HBV控制之间的联系。
纳入2020年至2021年在瑞金医院接受HBV筛查的患者进行暴露率估算。在乙肝核心抗体（HBcAb）阳性患者中，采用倾向评分匹配（PSM）研究风湿性疾病对暴露后HBsAg血清阳性率的影响。第二次PSM评估Ag/Ab差异。我们还研究了检测人类白细胞抗原B2（HLA-B27）患者的HBsAg患病率。
在33989例筛查患者中，风湿性疾病患者与非风湿性疾病患者的暴露率相当：分别为48.94%和49.86%。PSM首先产生2618对平衡配对。我们观察到，HBsAg阳性病例中的风湿性疾病患者明显少于阴性病例（<0.001）。在第二轮中，PSM匹配了279对，风湿性疾病患者的HBsAg（<0.001）和HBeAg（<0.05）阳性率显著较低，而HBsAb阳性率（<0.001）和水平（<0.01）显著较高。虽然在风湿性疾病范围内HBcAb值总体显著较低（<0.001），但强直性脊柱炎（AS）患者的HBcAb值显著高于其他风湿性疾病。我们发现HLA-B27阳性受试者的HBV感染明显少于阴性受试者（<0.001）。
在这项倾向评分匹配研究中，风湿性疾病患者在HBV控制方面具有优势。在风湿性疾病患者中，HBcAb水平以及HLA-B27的有益作用得到了突出体现。
