Supplementary Material for: Surveillance of liver function in uveitis with or without chronic HBV infection

Introduction: Immunosuppressive therapy for uveitis may cause liver damage. Methods: To investigate incidence of liver damage during uveitis treatment, we compared serological Hepatitis B core antibody (HBcAb) status with risk of liver dysfunction in all participants (n=992), in anterior uveitis (AU) (n=489) and combined of intermediate, posterior or panuveitis patients (IPPU) (n=503). The primary endpoint was incidence of elevated serum ALT level above two-fold upper limits of normal (ULN) within 6 months. Results: The incidence rate of primary endpoint for HBcAb negative and positive patients was 65 and 212 per 1,000 person years, respectively. The absolute rate difference was 147 (95% CI, 80-213) per 1,000 person years. HBcAb positivity was associated with a higher risk for primary endpoint in all participants (aHR, 3.53; 95% CI, 1.79-6.99; P value = 2.8×10-4) and in IPPU (aHR, 3.80; 95% CI, 1.61-9.01; P value = 0.002). No significant association with primary endpoint was observed for HBcAb positivity in AU (aHR, 3.21; 95% CI, 0.94-10.95; P value = 0.063). AU was mainly treated with topical eye drops (74.0%) whereas IPPU cases received systemic therapy including prednisone (94.0%), cyclosporine (80.9%) or other additionally combined immunomodulatory agents (14.9%). Conclusion: Non-infectious uveitis cases with HBcAb positivity have an increased risk of liver damage. This association was predominantly driven by IPPU but was not significant in AU suggesting that the association is mediated by systemic therapy.