Objective: To investigate the epidemiology of hepatitis B virus (HBV) infection in patients with rheumatoid arthritis (RA) in China and its association with RA disease characteristics. Methods: A cross-sectional study. A retrospective study was conducted on RA patients recruited from January 2001 to February 2023 in the Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital. Demographic and clinical data were collected including age, gender, disease duration, active smoking, RA disease activity, physical function, radiographic assessment, serological markers of HBV infection and liver function indicators. According to the status of HBV infection, RA patients were grouped as chronic HBV infection, resolved HBV infection and no HBV infection groups. The distribution of each group and the clinical characteristics of RA patients were analyzed. Results: Among 1 941 RA patients, 1 461 (75.3%) completed HBV screening, including 335 males (22.9%) and 1 126 females (77.1%), with a mean age of (55.4±13.1) years. The prevalence of chronic HBV infection was 10.1%(148/1 461), which was significantly higher in male patients than in females [14.6%(49/335) vs 8.8%(99/1 126), P<0.001], especially among those males born from 1970 to 1979[20.0%(7/35) vs 8.5%(17/201), P=0.037] and 1980-1989 [31.8%(7/22) vs 10.5%(14/133), P=0.007]. Among 148 RA patients with chronic HBV infection, there were 5 cases (3.4%) of chronic hepatitis B, 2 cases (1.4%) of HBV-associated cirrhosis and 1 case (0.7%) of hepatocellular carcinoma. The prevalence of resolved HBV infection was 57.6%(841/1 461). There were 472(32.3%) patients with no HBV infection and 267(56.6%) of them showed negative anti-HBs. Among all RA patients, 15 (1.0%) patients had abnormal liver function, of which 7 cases were drug-induced liver injury, 5 cases were chronic hepatitis B, 2 cases were non-alcoholic fatty liver disease, and 1 case was primary biliary cholangitis. Conclusion: Chronic HBV infection remains a common complication in RA patients in China, the infection rate is 10.1%, and the screening and management of HBV infection should be strengthened in clinical practice.
目的： 了解类风湿关节炎（RA）患者的乙型肝炎病毒（HBV）感染状态及其与临床特征的关系。 方法： 本研究为横断面研究。回顾性纳入2001年1月至2023年2月就诊于中山大学孙逸仙纪念医院风湿免疫科的RA患者，收集患者临床资料，包括年龄、性别、病程、吸烟、RA疾病活动、功能及放射学评估指标、HBV筛查及肝功能指标等。依HBV感染情况，将患者分为慢性HBV感染、既往HBV感染和无HBV感染组，分析各组感染分布情况和RA患者的临床特征。 结果： 共纳入1 941例RA患者，其中1 461例（75.3%）完成HBV筛查，其中男335例（22.9%），女1 126例（77.1%），年龄为（55.4±13.1）岁。148例（10.1%）RA患者合并慢性HBV感染，其中男性合并慢性HBV感染的发生率高于女性［14.6%（49/335）比8.8%（99/1 126），P<0.001］，尤其是在1970至1979年［20.0%（7/35）比8.5%（17/201），P=0.037］和1980至1989年［31.8%（7/22）比10.5%（14/133），P=0.007］出生的RA患者。148例慢性HBV感染者中，有5例（3.4%）慢性乙型肝炎，2例（1.4%）HBV相关肝硬化和1例（0.7%）肝细胞癌。841例（57.6%）RA患者合并既往HBV感染。472例（32.3%）RA患者无HBV感染，其中267例（56.6%）抗乙型肝炎表面抗体阴性。所有RA患者中，15例（1.0%）有肝功能异常，其中7例为药物性肝损伤，5例为慢性乙型肝炎，2例为脂肪肝，1例为原发性胆汁性胆管炎。 结论： 慢性HBV感染仍是我国RA患者的常见合并症，感染率10.1%，临床应加强对HBV感染的筛查与管理。.