title: Management of rheumatic disease with comorbid HBV or HCV infection.
abstract: Despite the major advances towards better prevention and treatment of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, these two chronic infections still account for ∼500 million infected people and 1 million deaths per year worldwide. Rheumatologists are frequently encountering patients with rheumatic disease who have co-existing HBV or HCV infection in daily clinical practice. Moreover, over the past decade, a number of studies have shown an increased risk of HBV reactivation and liver-related complications in HBV-infected patients treated with biologic agents (especially anti-TNF therapies). In this Review, the basic viral characteristics of HBV and HCV, as well as the natural course of chronic HBV and HCV infection, are outlined. Furthermore, a rational clinical approach for diagnosis and treatment of these comorbid conditions in the context of rheumatic disease is presented.
authors.affiliation: Athens University School of Medicine, 2nd Department of Medicine, Hippokration General Hospital, 114 Vass Sophias Avenue, 11527 Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vassilopoulos
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Calabrese
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D012216:Rheumatic Diseases / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000998:Antiviral Agents