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Table 3 Characteristics of patients with anti-HBs loss during treatment with biologic DMARDs

From: 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

Baseline Time to anti-HBs loss (months) Medication when anti-HBs loss occurred Comorbidities Total follow-up (months) HBV status and treatment after anti-HBs loss
Disease Serum HBV antibodies Biologic DMARD Conventional DMARD (accumulated dose, g) HCV Chronic liver diseasea DM CKD Viral load (IU/ml)b HBV reactivationc Antiviral therapy
HBs (mIU/ml) HBc Pd MTX LEF HCQ SSZ CsA
RA 10.1 15 TOF 3.0 0.6 0 181 236 0 ND 32 ND
RA 13.2 + 25 ETA 3.9 0 0 280 699 34 + Fatty liver + + 74 U
RA 13.4 11 TOF 0 0.8 0 141 0 0 ND 23 ND
RA 14.8 13 TOF 2.1 0.5 0 90 394 0 ND 30 U
RA 16.1 + 22 TCZ 4.4 0 9.2 0 713 0 PLDd + 47 U
RA 16.5 + 17 ABT 2.6 0 0 40 588 0 ND + 39 U
RA 17.3 + 7 ADA 1.1 0.5 0 84 294 0 Normal + 65 10e
RA 17.7 + 61 GOL 7.2 3.3 0 363 714 0 ND 61 U
RA 18.3 + 18 ETA 2.7 1.2 0 218 1092 0 Normal 68 U
RA 23.4 + 60 ADA 5.8 2.6 0 74 0 0 Normal 76 ND
RA 41.9 + 3 ETA 0.7 0 0 45 224 4 Normal 80 U
RA 44.7 + 10 RTX 2.5 0.6 0 28 182 8 + PLD 57 U
RA 56.3 42 TCZ 9.8 1.3 3.8 6 1295 0 Normal + 54 ND
AS 11.5 + 22 GOL 0 0 0 0 172 0 Normal 33 U − 
AS 14.3 7 GOL 0 0 0 0 163 0 Normal 51 ND
AS 21.7 + 34 ADA 0.4 0 0 0 294 0 Normal 75 U
AS 26.3 42 ADA 0.4 0 0 0 456 0 Normal 60 ND
AS 64.7 4 ADA 0.3 0 0 0 228 0 Normal 36 U
PsO 10.1 + 5 GOL 0.6 0 2.8 0 0 22 Fatty liver + 46 U
PsO 12.3 + 16 UST 0 0.5 0 0 0 90 Normal 62 U
PsO 17.3 + 17 UST 0 0 0 0 0 53 Fatty liver 47 U
PsA 27 + 28 ADA 3.8 0 1.4 0 56 0 ND 35 U
JIA 10.1 4 ETA 0.4 0.3 0 0 256 0 Normal 60 ND
  1. RA Rheumatoid arthritis, AS Ankylosing spondylitis, PsO Psoriatic arthritis, PSA Psoriasis, JIA Juvenile idiopathic arthritis, HBV Hepatitis B virus, HBs HBV surface antigen, HBc HBV core protein, DMARD Disease-modifying anti-rheumatic drug, Pd Prednisolone, MTX Methotrexate, LEF Leflunomide, HCQ Hydroxychloroquine, SSZ Sulfasalazine, CsA Cyclosporine, TOF Tofacitinib, ETA Etanercept, TCZ Tocilizumab, ABT Abatacept, ADA Adalimumab, GOL Golimumab, RTX Rituximab, UST Ustekinumab, HCV Hepatitis C virus, DM Diabetes mellitus, CKD Chronic kidney disease, PLD Parenchymal liver disease, U Undetectable, ND Not done
  2. aBased on ultrasound findings
  3. bAt any serial 6-monthly check during follow-up
  4. cHBV replication > 2 log increase from baseline or a new appearance of HBV DNA to > 100 IU/ml in people with previously stable or undetectable levels
  5. dIn Taiwan, ultrasound findings intermediate between “normal” and “cirrhosis” based on sonographic evaluation criteria for liver surface, liver parenchyma, hepatic vessels and spleen size, are diagnosed as “parenchymal liver disease” [16]
  6. eFirst prescribed biologic DMARD May 2013, anti-HBs loss December 2013; HBV DNA detected only once, in September 2017, with no recurrence as of August 2020