Chronic hepatitis B viral infection among RA patients—a cross-sectional control study

  • Naim Mahroum
  • Abdulla Watad
  • Shmuel Tiosano
  • Ashraf Hejly
  • Hussein Mahagna
  • Roy Waknin
  • Doron Comaneshter
  • Arnon D. Cohen
  • Howard AmitalEmail author
Original Article
Part of the following topical collections:
  1. Autoimmune Collection 2018


Background and objectives

Rheumatoid arthritis (RA) is the most common inflammatory joint disorder presenting also with extra-articular manifestations. As many other autoimmune diseases, it has been suggested that infectious diseases might contribute to its emergence. Hepatitis viruses were suggested by several reports as a trigger of RA onset. We aimed to assess the association between RA and chronic hepatitis B viral infection (HBV).


Patients with RA were compared with age- and sex-matched controls regarding the proportion of chronic HBV infection in a case-control study. The chi-square and t tests were used for univariate analysis, whereas a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services.


There was a significantly higher proportion of chronic HBV infection in RA patients compared with controls (1.19% vs 0.63%, respectively; p < 0.001). In a multivariate logistic regression analysis, RA was significantly associated with chronic HBV infection (OR = 1.89, 95%CI 1.55–2.29, p < 0.001).


Patients with RA have a greater proportion of chronic HBV infection than matched controls. Screening for HBV infection among RA patients may be warranted.


Autoimmune disease Autoimmunity Hepatitis B virus Rheumatoid arthritis 


Compliance with ethical standards

The study was approved by the ethical committee of CHS, located at the Soroka Medical Center, Beer-Sheva, Israel.

Conflict of interest

Naim Mahroum- no conflict of interests.

Abdulla Watad - no conflict of interests.

Shmuel Tiosano - no conflict of interests.

Ashraf Hejly - no conflict of interests.

Hussein Mahagna - no conflict of interests.

Roy Waknin - no conflict of interests.

Doron Comaneshter - no conflict of interests.

Arnon Cohen received research grants from Janssen, Novartis, AbbVie, and Sanofi. Other relationships: In the last 3 years, Prof. Arnon Cohen served as a consultant, advisor, or speaker to AbbVie; Amgen; Boehringer Ingelheim; Dexcel pharma; Janssen; Kamedis; Lilly; Neopharm; Novartis; Perrigo; Pfizer, Rafa, Sanofi, Sirbal; Taro.

Howard Amital- received research grants from Janssen, Novartis, AbbVie and Pfizer. Other relationships: In the last 3 years Howard Amital served as a consultant, advisor or speaker to AbbVie; Boehringer Ingelheim; Janssen; Neopharm; Novartis; Perrigo; Pfizer, Rafa, Sanofi, Sanofi, Taro, Roche.


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  • Naim Mahroum
    • 1
    • 2
  • Abdulla Watad
    • 1
    • 2
  • Shmuel Tiosano
    • 1
    • 2
  • Ashraf Hejly
    • 1
  • Hussein Mahagna
    • 1
  • Roy Waknin
    • 2
  • Doron Comaneshter
    • 3
  • Arnon D. Cohen
    • 3
    • 4
  • Howard Amital
    • 1
    • 2
    Email author
  1. 1.Department of Medicine ‘B’, Zabludowicz Center for Autoimmune DiseasesSheba Medical CenterTel-HashomerIsrael
  2. 2.Sackler Faculty of MedicineTel-Aviv UniversityTel-AvivIsrael
  3. 3.Chief Physician’s OfficeClalit Health Services Tel AvivTel-AvivIsrael
  4. 4.Siaal Research Center for Family Medicine and Primary Care, Faculty of Health SciencesBen Gurion University of the NegevBeer ShevaIsrael

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