title: Anti-tumor necrosis factor treatment in occult hepatitis B virus infection: a retrospective analysis of 62 patients with psoriatic disease.
abstract: 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 (HBsAg), 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.
authors: N
authors: N
authors: Cassano
authors: V
authors: V
authors: Mastrandrea
authors: M
authors: M
authors: Principi
authors: F
authors: F
authors: Loconsole
authors: N
authors: N
authors: De Tullio
authors: A
authors: A
authors: Di Leo
authors: G A
authors: GA
authors: Vena
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000276:immunology / Q000494:pharmacology*; D000906:Antibodies / Q000276:immunology / Q000494:pharmacology; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000494:pharmacology; D061067:Antibodies, Monoclonal, Humanized; D002353:Carrier State / Q000276:immunology; D004338:Drug Combinations; D000068800:Etanercept; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000032:analysis / Q000276:immunology; D006515:Hepatitis B virus / Q000502:physiology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology / Q000494:pharmacology; D000069285:Infliximab; D019259:Lamivudine / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology* / Q000503:physiopathology; D018124:Receptors, Tumor Necrosis Factor / Q000276:immunology; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology; D017735:Virus Latency / Q000187:drug effects* / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents; D000906:Antibodies; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D004338:Drug Combinations; D006514:Hepatitis B Surface Antigens; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D018894:Reverse Transcriptase Inhibitors; D014409:Tumor Necrosis Factor-alpha; D019259:Lamivudine; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept