Potential Role of Peripheral Blood Lymphocyte Subsets in Rheumatoid Arthritis Patients Concurrent with Hepatitis B Virus Infection：A Retrospective Cohort Study

Abstract

Abstract Background: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease. Previous studies have shown that RA patients have high HBV infection rates. Hepatitis B virus (HBV) infection has a deleterious effect on the radiographic and clinical outcomes of patients with RA. This study investigated the composition of peripheral blood lymphocytes in patients with RA and concurrent HBV infection. Identifying peripheral blood lymphocyte subsets could provide insights into their deleterious effects on clinical outcomes among these patients. Methods To investigate the composition of peripheral blood lymphocytes in patients with RA or RA with concurrent HBV infection, 298 patients were recruited from a prospective cohort of patients with RA. Based on the HBV infection status, 43 patients with RA and concurrent HBV infection were assigned to the HBV group (HBV-RA group), while 255 patients without HBV infection were assigned to the control group. Patients in the HBV-RA group were split into groups with HBV DNA levels below the lower limit of quantification (< 20 IU/ml, HBV DNAlow group) and above the lower limit of quantification (≥ 20 IU/ml, HBV DNAhigh group). Demographic, clinical, and laboratory data were also collected. Results Compared with those of the control group, a higher percentage of CD19+ B cells and CD8+ T cells and a lower CD4+/CD8+ ratio were observed in the HBV-RA group (all P < 0.05). The same trend was observed in the HBV DNAhigh group compared to the HBV DNAlow group (all P < 0.05). In addition, according to multivariable logistic regression analysis, male sex, DAS-28 ≥ 2.6, and a high proportion of CD19+ B and CD8+ T cells were unfavorable factors for HBV-infected RA (all P < 0.05). Conclusion The composition of peripheral blood lymphocytes in patients with RA and concurrent HBV infection differs from that of patients with RA without HBV infection. Male sex, DAS-28 ≥ 2.6, the high proportion of CD19+ B and CD8+ T cells were unfavorable factors for RA concurrent with HBV infection; therefore, these factors warrant greater clinical attention.