Zhu Fenglin, Wang Miao, Zhang Xuhong, Zhao Guoqing, Gao Hongyan, Zhou Lamei
Department of Rheumatology, The First Affiliated Hostipal of Chonqqing University of Chinese Medicine, Chongqing, Jiangbei, 410000, China.
Department of Rheumatology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi, 214000, Jiangsu, China.
Heliyon. 2024 Dec 26;11(1):e41444. doi: 10.1016/j.heliyon.2024.e41444. eCollection 2025 Jan 15.
Rheumatoid arthritis (RA) is associated with a high rate of hepatitis B virus (HBV) infection. A large proportion of HBV reactivation may occur in RA patients after immunosuppression treatment, while fulminant hepatitis may occur in severe cases. Immunosuppressants are fundamental medications for the treatment of RA but carry the risk of inducing HBV reactivation. This inherent contradiction poses challenges throughout the immunosuppressive treatment process in patients with RA. Recently, numerous studies have been conducted on the contradictory therapeutic mechanisms between RA treatment and HBV infection, including aspects of innate immunity, adaptive immunity, and related signalling pathways. In this article, we review the immunological mechanisms underlying the onset of RA and HBV infections, providing a reference for determining appropriate treatment plans to reduce therapeutic contradictions and thereby reduce the risk of HBV reactivation in patients with RA combined with HBV infection.
类风湿关节炎（RA）与乙型肝炎病毒（HBV）的高感染率相关。很大一部分HBV再激活可能发生在RA患者接受免疫抑制治疗后，严重情况下可能会出现暴发性肝炎。免疫抑制剂是治疗RA的基础药物，但有诱发HBV再激活的风险。这种内在矛盾在RA患者的免疫抑制治疗过程中带来了挑战。近年来，针对RA治疗与HBV感染之间相互矛盾的治疗机制开展了大量研究，包括固有免疫、适应性免疫及相关信号通路等方面。在本文中，我们综述了RA发病及HBV感染的免疫机制，为确定合适的治疗方案提供参考，以减少治疗矛盾，从而降低合并HBV感染的RA患者发生HBV再激活的风险。
