Risk factors for losing hepatitis B virus surface antibody in patients with HBV surface antigen negative/surface antibody positive serostatus receiving biologic disease-modifying anti-rheumatic drugs: a nested case-control study

Table 2 Risk factors associated with loss of HBV surface antibody

	Univariate analysis		Multivariate analysis
	Risk ratio (95% CI)	p-value	Risk ratio (95% CI)	p-value
Age	1.02 (0.99–1.05)	0.153
Sex
Female	1 (reference)	0.097
Male	0.48 (0.20–1.14)	0.097
Rheumatic disease
Rheumatoid arthritis	1 (reference)	0.582
Ankylosing spondylitis	0.60 (0.21–1.72)
Psoriatic arthritis/Psoriasis	0.87 (0.28–2.76)
Juvenile idiopathic arthritis	2.73 (0.29–25.57)
Anti-HBV core antigen positive	1.23 (0.51–2.95)	0.641
Baseline serum anti-HBs titer (mIU/ml)
Lower vs higher (continuous)	0.93 (0.89–0.97)	0.001	0.93 (0.88–0.97)	0.002
> 100	1 (reference)		1 (reference)
≤ 100	46.8 (10.09–∞)	< 0.001	43.98 (9.34–∞)	< 0.001
Biologic DMARDs
Anti-TNF	1 (reference)	0.204
Not anti-TNF	1.80 (0.73–4.49)	0.204
Conventional DMARDs
Methotrexate	1.00 (1.00–1.00)	0.942
Sulfasalazine	1.00 (1.00–1.00)	0.135
Hydroxychloroquine	1.00 (1.00–1.01)	0.515
Cyclosporine	1.00 (0.99–1.02)	0.888
Leflunomide	1.00 (1.00–1.00)	0.958
Prednisolone	1.00 (1.00–1.00)	0.064
Comorbidity
Prior alanine transaminase elevation^a	2.93 (0.59–14.54)	0.188
Hepatitis C virus antibody positive	2.64 (0.54–12.92)	0.232
Diabetes mellitus	4.76 (1.48–15.30)	0.009	0.85 (0.19–3.92)	0.838^b
Chronic liver disease	2.62 (0.90–7.66)	0.079
Chronic kidney disease	14.00 (2.22–88.23)	0.005	45.68 (2.39–871.5)	0.011^c

Anti-HBs Hepatitis B virus surface antibody, DMARD Disease-modifying anti-rheumatic drug, TNF Tumor necrosis factor
^aMore than five-fold upper reference of 40 IU/L
^bBaseline anti-HBs as continuous variable
^cBaseline anti-HBs continuous + chronic kidney disease + diabetes mellitus

ISSN: 2523-3106