Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya63295810.26442/00403660.2024.05.202707ReviewsОбзорыReview ArticleChronic hepatitis B in rheumatic diseases: issues of screening and reactivation of infection: A reviewХронический гепатит В при ревматических заболеваниях: вопросы скрининга и реактивации инфекцииhttps://orcid.org/0000-0002-0928-3911GridnevaGalina I.ГридневаГалина Игоревна
Russian Federation

кандидат мед. наук, науч. сотр. лаб. коморбидных инфекций и вакцинопрофилактики

gigridneva@mail.ruhttps://orcid.org/0000-0001-7091-2054BelovBoris S.БеловБорис Сергеевич
Russian Federation

доктор мед. наук, зав. лаб. коморбидных инфекций и вакцинопрофилактики

belovbor@yandex.ruhttps://orcid.org/0000-0002-1833-5357AronovaEvgeniia S.АроноваЕвгения Сергеевна
Russian Federation

кандидат мед. наук, науч. сотр. лаб. коморбидных инфекций и вакцинопрофилактики

eugpozd@mail.ruNasonova Research Institute of RheumatologyФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»03062024965Issues of rheumatologyВопросы ревматологии5235302905202429052024Copyright ©; 2024, Consilium MedicumCopyright ©; 2024, ООО "Консилиум Медикум"2024Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/632958

Patients with rheumatic diseases infected with hepatitis B virus (HBV) are difficult to manage not only due to the presence of risk factors for the development and rapid progression of liver cirrhosis, but also due to the likelihood of reactivation of this infection. Despite the successes achieved in the fight against HBV, the virus cannot be completely defeated due to the presence of hidden forms of the disease, escaping the field of vision of a rheumatologist and an infectionist. Based on the results of the analysis of current publications, the paper presents the rationale for a complete immunological screening of patients with rheumatic diseases when prescribing antirheumatic therapy. The issues of the role of COVID-19 in the exacerbation of chronic viral hepatitis B, antiviral prevention and monitoring are discussed, the classification of antirheumatic drugs according to the risk of HBV reactivation is presented.

Пациенты с ревматическими заболеваниями, инфицированные вирусом гепатита В (hepatitis B virus – HBV), трудны для курации вследствие не только наличия факторов риска развития и быстрого прогрессирования цирроза печени, но и вероятности реактивации данной инфекции. Несмотря на достигнутые успехи в борьбе с HBV, вирус не может быть полностью побежден в связи с имеющимися скрытыми формами течения болезни, ускользающими из поля зрения ревматолога и инфекциониста. В статье на основании результатов анализа актуальных публикаций представлено обоснование полного иммунологического скрининга пациентов с ревматическими заболеваниями при назначении антиревматической терапии. Затронуты вопросы роли коронавирусной инфекции в обострении хронического вирусного гепатита В, противовирусной профилактики и мониторинга, представлена классификация антиревматических препаратов по степени риска реактивации HBV с учетом новейших данных.

immunosuppressive therapyantirheumatic drugschronic viral hepatitis BHBSAgscreeningreactivationpreventionиммуносупрессивная терапияантиревматические препаратыхронический вирусный гепатит Вповерхностный антиген вируса гепатита ВскринингреактивацияпрофилактикаThe article was prepared as part of the research work of Nasonova Research Institute of Rheumatology (state assignment №1021051503137-7).Статья подготовлена в рамках научно-исследовательской работы ФГБНУ «НИИ ревматологии им. В.А. Насоновой» (государственное задание №1021051503137-7).Aguirre A, Yazdany J. Hepatitis B Screening Before Biologic or Targeted Synthetic Disease-modifying Antirheumatic Drug Therapy: Many Roads to Improvement. J Rheumatol. 2022;49(1):1-4. DOI:10.3899/jrheum.211000Capkin E, Yazıcı A, Karkucak M, et al. Evaluation of hepatitis serology and frequency of viral reactivation in patients with inflammatory arthritis receiving biologic agents: a multicenter observational study. Rheumatol Int. 2023;43(3):523-31. 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