TITLE:
Suppression of Methotrexate-Induced Elevations in the Serum Alanine Aminotransferase Level of Patients with Rheumatoid Arthritis Who Had Prior Hepatitis B Infection
AUTHORS:
Osamu Noguchi, Yukio Nakamura, Hiroyuki Kato
KEYWORDS:
Rheumatoid Arthritis, De Novo Hepatitis B, MTX-Induced Liver Injury, ALT, Biological Agents
JOURNAL NAME:
Health,
Vol.10 No.5,
May
15,
2018
ABSTRACT: Background: Hepatitis after the reactivation of hepatitis B virus (HBV) has been recognized serious in the patients with rheumatoid arthritis (RA) treated with biologics. Objectives: The objective of the present study was to search some common background which might be relevant to the host factors that provoke such a serious hepatitis. Methods: We retrospectively collected and analyzed all data of serum alanine aminotransferase (ALT) levels in selected patients with RA at random. Results: A significant association (P P P = 0.73) in the anti-HBcAb-positive RA group. In addition, the anti-HBcAb-positive RA patients showed significantly lower mean serum level of ALT (P P Conclusions: The anti-HBcAb-positive RA group showed the suppression of MTX-induced elevations in serum ALT level. However, this suppression was not found in patients experienced in the treatment with biologics, although it was preserved in those who had not experienced biologics. Failure of this suppressive mechanism of ALT in anti-HBcAb-positive RA patients treated with biologics could be possibly associated with serious hepatitis after the reactivation of HBV infection.