Background/Purpose:

The prevalence of chronic hepatitis B virus (HBV) infection is high in China. 4% patients with HBV infection can present with polyarthritis and positive rheumatic factor similar to RA, which implied similar pathogenic mechanism.We aimed to investigate the association between HBV infection and serological, radiological or histological disease status in RA.

Methods: 223 continuous hospitalized Chinese patients with RA were enrolled retrospectively. Clinical and laboratory data including HBV detection, and hand X ray were collected. Among 133 active RA patients, synovium was obtained by closed-needle biopsy from inflamed knee joint. Serial tissue sections were stained immunohistochemically for HBV surface antigen (HBsAg), CD79a, CD20, CD38, CD68, CD3, and CD34. Densities of positive-staining cells and synovitis score were determined.

Results: According to HBV infection status, 25/223 had chronic HBV infection (including 4 chronic hepatitis B and 21 HBV carriers), 72/223 had past HBV infection and 126/223 had no HBV infection. The prevalence of HBsAg positivity and chronic hepatitis B in RA was 11.2% and 1.7%, not significantly different with age-matched general Chinese population (8.7% from 2006 Chinese national epidemiological survey and 1.0% from 2005 local survey, respectively, P>0.05). Clinical parameters, DAS28 or Sharp scores showed no significant difference among chronic HBV infection, past HBV infection and no HBV infection groups in 206 active RA or 140 active RA patients without any corticosteroid or DMARDs treatment (all P>0.05). Synovial immunohistochemical staining showed negative HBsAg in 10 HBV carriers and 10 past HBV infection patients. Except for higher sublining CD3+ cell density in past HBV infection group, Krenn’s synovitis score, mean densities of sublining positive-staining cells (CD20, CD38, CD79a and CD68) and CD34+ microvessel counts showed no significant difference among RA patients with HBV carrier, past HBV infection or no HBV infection (all P>0.05).

Conclusion: The prevalence of HBV infection in RA patients was consistent with general Chinese population. Chronic HBV infection have no significant effect on disease activity, synovitis or joint destruction in RA, implying that chronic HBV infection may play neither promotive nor protective role in RA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/no-significant-effect-of-hepatitis-b-virus-infection-on-disease-activity-synovitis-or-joint-destruction-in-rheumatoid-arthritis/