Anti-TNF therapy in patients with HBV infection--analysis of 87 patients with inflammatory arthritis.
This study aims to investigate the incidence of hepatitis B virus (HBV) reactivation in inflammatory arthritis (IA) patients with HBV infection using anti-tumor necrosis factor (TNF) agents and evaluate the efficacy of antiviral therapy in reducing the risk of viral reactivation in chronic HBV infection. IA patients using anti-TNF agents from six centers were enrolled. Their HBV infection conditions and ALT and HBV-DNA levels were monitored periodically. Among the six chronic hepatitis B patients, HBV reactivation was found in two patients without antivirus prophylaxis and no viral replication was detected in the other four patients with antivirus prophylaxis. In the 31 inactive carriers, the increase of viral load was detected in 6 of 22 (27.3 %) patients without antiviral prophylaxis, and there was no viral reactivation in the other 9 patients with antiviral prophylaxis. HBV reactivation was not found in the 50 patients with resolved HBV infection. It is suggested that anti-TNF therapy might increase the risk of HBV reactivation in patients with chronic HBV infection, and antiviral prophylaxis could effectively decrease the risk. Anti-TNF agents seem to be safe in patients with resolved HBV infection.
Hua
H
Ye
Xue-wu
XW
Zhang
Rong
R
Mu
Lin-kai
LK
Fang
Jie-ruo
JR
Gu
Jin
J
Lin
Jin-feng
JF
Du
Jin-wei
JW
Chen
Yi-jia
YJ
Chen
Li-jun
LJ
Wu
Xue-feng
XF
Pang
Zhan-guo
ZG
Li
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000276:immunology / Q000628:therapy*; D000068800:Etanercept; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000276:immunology / Q000628:therapy*; D006515:Hepatitis B virus; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage; D007249:Inflammation / Q000503:physiopathology / Q000628:therapy*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000276:immunology / Q000628:therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D019562:Viral Load; D055815:Young Adult
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept