Prevalence Of Hepatitis B Virus Infection In Patients With SLE, AS, RA And The Clinical Implications

Objective:To investigate hepatitis B virus (HBV) infection of patients of Han nationality of Shandong Province who suffer from sysremic lupus erythematosus (SLE), ankylosing spondylitis (AS) and rheumatoid arthritis (RA), to debate its effective factors according to its clinical information, and to discuss its influence on disease activities brought by HBV infection and its clinical significance.Participants and Methods:To gather patients with SLE, AS and RA hospitalised at Shandong Provincial Hospital from January1,2005to December31,2012as seperate case of illness (SLE Group, AS Group and RA Group), collect their serology biomarker detection results, simultaneously records their clinical information including their symptoms, physical signs and laboratory detection results. Health control group consists of people who took health examinations in Shandong Provincial Hospital from January1,2010to July31,2011, their HBV serology detection results are collected for statistical analysis. Continuous variable data is indicated by math average deviation±standard deviation, using independent specimen t to detect and analysis, classified variable data is indicated by rate, using χ2to detect and analysis, P＜0.05is regarded as statistical significance. All data is processed by SPSS13.0software. Results:1. Health control (HC) group includes11558people,6734of them are male, and4824are female. According to the statistics, HBV serology index differs in sex, HBsAg and HBeAg positive rate of male is significantly higher than that of female (P=0.004vs P=0.001), but HBsAb positive rate and HBeAb positive rate of female is higher than that of male (P=0.008vs P=0.015). All the differences have statistical significance (P＜0.05), HBcAb positive rate has no sex difference (P>0.05).2. SLE group includes960patients,86of them are male, and874are female. According to the statistics, the positive rate of HBsAg, HBeAb,and HBcAb in whole group and in female group is significantly lower than that of HC group, and the difference has statistical significance (P＜0.05). HBeAb has no statistically significant difference (P>0.05). There is no statistical significance of difference between male of SLE group and HC group (P＜0.05). There is no sex difference of HBsAg, HBsAb, HBeAg, HBeAb and HBcAb positive rate among people of this group (P>0.05). Refered to desease activities, HBsAg positive and HBsAg negative have no statistical difference.3. AS group includes393patients,292of them are male, and101are female. There is no sex difference of positive rate of HBsAg, HBsAb, HBeAg, HBeAb and HBcAb (P>0.05). AS group has higher HBsAg and HBsAb positive rate than HC group and the difference has statistical significance (P＜0.05); male’s HBsAg and HBsAb positive rate has statistical difference, but female’s HBsAg positive rate has no statistical significance though it is higher than that of HC group (P>0.05), And all the differences of HBsAb、HBeAb、HBcAb positive rate have no statistical significance (P>0.05). There is no statistical differences between HBsAg positive group and negative group as well as their clinical performation and relative detection results (P>0.05).4. RA group includes667patients,146of them are male, and521cases are female. There is no statistical differences between RA group’s HBsAg, HBeAg, HBeAb positive rate and HC group’s (P>0.05); RA group’s HBsAg and HBeAb positive rate are higher than that of HC group, and the difference has statistical significance (P＞0.05), but no sex difference (P>0.05). The group has no sex difference of HBsAg,HBsAb, HBeAg, HBeAb, and HBcAbpositive rate (P>0.05). According to the analysis of clinical performance and laboratory detection results, HBsAg positive group has significantly higher ESR, CRP and lower PLT than HBsAg negative group, and the difference has statistical significance (P>0.05).Conclusion:1. The HBsAg positive rate of SLE patients is obviously lower than that of healthy people, this phenomena is probably caused by raised IL-10or IFN-α level. Raised IFN-a level might play a beneficial role in HBV clearance. HBV infection has no relativity to disease activities of SLE patients.2. The HBsAg positive rate of AS patients is higher that of HC group, SLE patients, and RA patients, it is possible that AS group has higher rate infected with HBV because of HLA-B27gene inside their body. There is no relativity between HBV infection and disease activities of AS patients.3. There is no clear difference of HBsAg positive rate between RA patients and HC group. HBV infection has influence on disease activities of RA patients, maybe HBV is involved in the was no significant difference with the healthy control people. But HBV infection may infect the activity of disease in RA patients, the first reason is that HBV participates in the nosogenesis of RA and increases disease activities, the second reason is that RA patients have been given deficient strength treatment.