Clinical Features Of 59 Patients With Systemic Lupus Erythematosus Complicating Hepatitis B Virus Infection

Objective:To analysis the clinical features and used of hormone or normone+immunosuppressani wneiner neea to anuviral treatment at the same time of inpatients with systemic lupus erythematosus (SLE) complicating with hepatitis B virus(HBV) infection in the First Affiliated Hospital of Guangxi Medical University in recent five yeas.Methods:In this study,59 SLE patients with hepatitis B virus infection were collected from January 12010 to january 12015 in the First Affiliated Hospital of Guangxi Medical University as a case study group. The control group from the same period in hospital 118 cases of SLE who were not infected with hepatitis B virus,according to 1:2 ratio from the same period of hospitalization in patients with SLE noninfectious stratified random sample,to ensure the two groups of sex,age.To collect the two group patients’ general situation,clinical data,related complications,laboratory index,hormone and immune inhibitor use. among study group,only 39 patients return to hospital regulary or readmission,collecting this patients liver function, HBV-DNA cppies,hormone and immune inhibitor use projects for six months to 3 years.Results:1. The study group and the control group are compared with clinical manifestation and laboratory examination. The study group have a significantly higher prevalence of liver involvement, thrombocytopenia, anti-cardiolipin antibody positive (P<0.05). However, The control group have a significantly higher prevalence of anti SS-A antibody positive (P<0.05)2. The group of antiviral patient’s HBV-DNAcopies,liver function changes: There are 24 patients use antiviral treatment and hormone and immune inhibitor at the same time.17 patients HBV-DNA copy>1.0x103/ml,of which 7 patients with hepatitis(drug-induced or autoimmune hepatitis have excluded); 6 patients HBV-DNA copy<1.0x103/ml,of which 3 patients with hepatitis. There are 20 petients’HBV-DNA copy>1.0x103/ml or with hepatitis, accounting for 86.96%. After the treatment of SLE and antiviral,20 patients HBV-DNA copy< 1.0x103ml all the time, however,of which 1 patient with hepatitis, compared with before antiviral,3 patients HBV-DNA copy are decreased,but not sustain in less than 1.0x103ml, of which 2 patients with hepatitis.This three patients were using megadose hormone+cyclophosphamide pulse+Mycophenloate Mofetil Tablets or cyclosporin A. There are 4 petients’ HBV-DNA copy>1.0x103/ml or with hepatitis, accounting for 17.39%.If antiviral treatment at the same time, there were significantly lower HBV-DNA copy increasing or hepatitis(P<0.001).All patients were using megadose hormone or megadose hormone+immunosuppressive therapy.3. The group of nonantiviral patient’s HBV-DNAcopies,liver function changes:There are 16 patients not use antiviral treatment and hormone and immune inhibitor at the same time.all patients’ HBV-DNA copy< 1.0x103ml, and asumed hepatitis b virus carriers. After the treatment of SLE,10 patients’HBV-DNA copy> 1. Ox 103/ml,of which 5 patient with hepatitis.6 patients HBV-DNA copy> 1.Ox 103/ml,of which 3 patients with hepatitis(drug-induced or autoimmune hepatitis have excluded),3 patients asumed hepatitis b virus carriers. There are 13 petients’ HBV-DNA copy>1.0x103/ml or with hepatitis, accounting for 81.25%. If nonantiviral treatment at the same time, there were significantly higher HBV-DNA copy increasing or hepatitis(P<0.001).The time of this 13 patients with hepatitis or HBV-DNA copy increase were 1 week to 1.5 years.All patients were using megadose hormone or megadose hormone+immunosuppressive therapy.Conclusion:1. SLE complicating with HBV infection patient’s clinical features: Having a significantly higher prevalence of liver involvement, thrombocytopenia,anti cardiolipin antibody positive,Having a significantly lower prevalence of anti SS-A antibody positive.2. SLE complicating with HBV infection patients are advised to antiviral and test liver function、HBV-DNA copy regularly when use hormone or hormone or immunosuppressant.