ANTI-TUMOR NECROSIS FACTOR TREATMENT IN OCCULT HEPATITIS B VIRUS INFECTION: A RETROSPECTIVE ANALYSIS OF 62 PATIENTS WITH PSORIATIC DISEASE

作者：Cassano N; Mastrandrea V; Principi M; Loconsole F; De Tullio N; Di Leo A; Vena G A^*

来源：Journal of Biological Regulators and Homeostatic Agents, 2011, 25(2): 285-289.

• psoriasis
• anti-TNF biologicals
• adalimumab
• etanercept
• infliximab
• hepatitis B
• HBV occult carriers

One of the problems possibly related to the use of biological agents targeting tumor necrosis factor (TNF)-alpha is the increased risk of infections, including the activation of hepatitis B virus (HBV). HBV activation can occur in carriers of hepatitis B surface antigen (liBsAg), but the risk may also involve the HBsAg-negative (anti-HBc +/- anti-HBs) occult carriers. Precise data on the safety of anti-TNF and/or other immunosuppressive drugs in HBV occult carriers are not available. We performed a retrospective analysis of 62 psoriatic patients with occult HBV infection treated with anti-TNF biological agents over a period of approximately 4 years: 44 subjects were treated with etanercept, 8 with infliximab and 10 with adalimumab. During the observational treatment period, no signs of HBV activation were observed. Only in one patient the reappearance of HBsAg, without detectable HBV-DNA, was noted before retreatment with etanercept and after 10 months from discontinuation of the previous course. In this patient etanercept was re-administered in association with lamivudine without any adverse event. Our results suggest the overall safety of treatment with anti-TNF drugs in HBV occult carriers, although a careful and constant monitoring of virological markers is required in such patients during treatment with anti-TNF drugs in order to have an early recognition of viral reactivation.

• 出版日期2011-6