Lack of hepatitis B virus reactivation after anti-tumour necrosis factor treatment in potential occult carriers with chronic inflammatory arthropathies.
BACKGROUND
Hepatitis B virus (HBV) reactivation in patients positive for antibody to HB core antigen (anti-HBc), negative for HB surface antigen (HBsAg) and HBV-DNA (potential occult HBV carriers), treated with anti-tumor necrosis factor (TNF)α, is a debated question. The aim of the study was to evaluate the safety of anti-TNFα therapy in anti-HBc positive/HBsAg negative subjects with rheumatoid arthritis (RA) and spondyloarthropathy (SpA).


METHODS
All consecutive HBsAg negative RA and SpA outpatients referring to the Immuno-Rheumatology Institute at the S. Andrea hospital, Sapienza, University of Rome who had to undergo anti-TNFα therapy.


RESULTS
Among the 169 enrolled subjects, 20 (12%) were potential occult HBV carriers (anti-HBc positive, HBsAg and HBV-DNA negative patients with or without anti-HBs). During the follow-up (mean ± SD 45 ± 22 months), aminotransferases and HBV-DNA, tested every two and six months respectively, did not change.


CONCLUSIONS
This study confirms the substantial safety of anti-TNFα therapy in potential occult HBV carriers RA and SpA patients.
Dept. of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
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Biondo
Dept. of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
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Germano
Dept. of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
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Pietrosanti
Dept. of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
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Canzoni
Dept. of Digestive and Liver Disease, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
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Marignani
Dept. of Infectious and Tropical Diseases, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy.
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Stroffolini
Dept. of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
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Salemi
Dept. of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy. Electronic address: raffaele.damelio@ospedalesantandrea.it.
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D'Amelio
D000368:Aged; D018501:Antirheumatic Agents / Q000276:immunology / Q000494:pharmacology* / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy / Q000276:immunology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology; D002353:Carrier State / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D025242:Spondylarthropathies / Q000188:drug therapy* / Q000276:immunology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014775:Virus Activation / Q000187:drug effects*
D018501:Antirheumatic Agents; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha
Anti-TNFα; HBV reactivation; HBcAb-positive; Rheumatic diseases