Presence of hepatitis B virus in synovium and its clinical significance in rheumatoid arthritis

• Published in: Arthritis research & therapy 2018-06, Vol.20 (1), p.130-130, Article 130
• Main Authors: Chen, Yu-Lan, Jing, Jun, Mo, Ying-Qian, Ma, Jian-Da, Yang, Li-Juan, Chen, Le-Feng, Zhang, Xiang, Yan, Tao, Zheng, Dong-Hui, Pessler, Frank, Dai, Lie
• Format: Article
• Language: English
• Subjects: Diagnosis; Health aspects; Hepatitis B virus; Medical examination; Radiographic progression; Rheumatoid arthritis; Synovial biopsy; Synovial membranes; Synovium
• ISSN: 1478-6362; 1478-6354; 1478-6362
• DOI: 10.1186/s13075-018-1623-y

Previous studies have revealed that hepatitis B virus (HBV) infection may be related to rheumatoid arthritis (RA), but there are no studies on the presence of HBV antigens or nucleic acid in synovium from patients with RA with HBV infection. In the present study, we investigated the presence of HBV in the synovium and its clinical significance in RA. Fifty-seven consecutive patients with active RA (Disease Activity Score 28-joint assessment based on C-reactive protein ≥ 2.6) and available synovial tissue who had completed 1 year of follow-up were recruited from a prospective cohort. The patients were divided into chronic HBV infection (CHB, n = 11) and non-CHB groups according to baseline HBV infection status. Clinical data were collected at baseline and at 1-, 3-, 6-, and 12-month follow-up. Radiographic changes of hand/wrist at baseline and month 12 were assessed with the Sharp/van der Heijde-modified Sharp score (mTSS). HBV in synovium was determined by immunohistochemical staining for hepatitis B virus surface antigen and hepatitis B virus core antigen (HBcAg) and by nested PCR for the HBV S gene. HBcAg was found in the synovium of patients with RA with CHB (7 of 11, 64%), which was confirmed by PCR for the HBV S gene. Compared with the non-CHB group, more CD68-positive macrophages, CD20-positive B cells, and CD15-positive neutrophils infiltrated the synovium in the CHB group (all p