Dados do Trabalho

Title

Hepatitis B and C, Syphilis and HIV Serologies in Spondyloarthritis Patients from a Tertiary Service in Manaus – AM

Background

Immunosuppressant drugs, such as DMARDs and biologics play an important role in the treatment of rheumatologic diseases. Those drugs are related with increased susceptibility of infections, specially intracellular and viral infection, leading to viral reactivation or more serious diseases. The aim of the present study was to demonstrate the frequency of antibodies against HBV, HCV, syphilis and HIV in Spondyloarthritis patients on tertiary service from Manaus/AM.

Materials and methods

Retrospective descriptive study of medical records of patients from the spondyloarthritis ambulatory in Manaus

Results

From 237 medical records, 140 were complete with information necessary about serologies. The study population had a mean age of 49 years (Range 19 to 77 years) most of them were male (68.5%) and had diagnosis of ankylosing spondylitis (65%). Regarding the HBV serology, the frequency of HBsAg positivity was 2.8% (4 patients), all the cases were diagnosed during immunosuppressant therapy, being on using etanercept and the others DMARDs; 61.4% of the patients were Anti-HBs negative, showing a lack of HBV vaccination; and 9.2% had Anti-HBc positivity, showing previous infection before the immunosuppressant treatment. The patients showing previous HBV infection are monitored and 4 of them use biologics (3 etanercept and 1 infliximab). None of the patients had Anti-HCV or VDRL positivity and 1 patient had Anti-HIV 1 positive during treatment with metotrexate.

Conclusions

Viral infection on rheumatological patients is a very important topic. As we could see, most of the patients were not vaccinated for HBV, which is a huge flaw, especially in the Amazon State that is and endemic area for HBV. The patients with active infection and previous infection are a risk group for reactivation, needing to be followed-up closely by the hepatologist and rheumatologist. The HIV positive patient has Psoriatic Arthritis, and those cases need to be followed-up with the infectologist and rheumatologist for the best outcome for the patient.