title: Lack of evidence of viral reactivation in HBsAg-negative HBcAb-positive and HCV patients undergoing immunosuppressive therapy for psoriasis.
abstract: BACKGROUND
  HBV and HCV reactivation have been widely reported in patients undergoing immunosuppressive therapy (IT); however, few data are available on the risk of reactivation in patients with psoriasis receiving IT. The aim of our study was to assess the prevalence of HBV and HCV infection in patients with psoriasis and to evaluate the effects of IT during the course of the infection.
  
  
  METHODS
  The study included psoriatic patients who attended an Italian tertiary referral hospital from 2009 to 2012. A total of 224 patients were enrolled. We evaluated: HBV and HCV markers, type of IT and the occurrence of viral reactivation. The observational period ranged from the beginning of IT to the last visit, with a mean follow-up period of 54 months.
  
  
  RESULTS
  Two hundred and twenty patients (135 males and 89 females; mean age 59 years; range 18-86 years) with psoriasis, with or without psoriatic arthritis, receiving conventional IT and/or biological drugs were tested for markers of infection. We identified 23/224 patients (10.2%) with isolated positivity for HBcAb positivity, 36/224 (16%) with positivity for HBsAb/HBcAb, and 15/224 (6.6%) with positivity for HCV-Ab. No patient was HBsAg positive, none of them underwent pre-emptive therapy with lamivudine or other antiviral drugs and no one showed episodes of viral reactivation.
  
  
  CONCLUSIONS
  The prevalence of HBsAg in patients with psoriasis is lower than that observed in the general population. The prevalence of isolated positivity for HBcAb and of combined positivity for HBcAb and HBsAb is 10.2% and 16%, respectively. The prevalence of HCV infection (HCV-RNA+) is 4%. In patients with psoriasis and HCV-Ab or HBcAb positivity, the IT seems to be safe, regardless of the type of drugs.
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", Via S. Pansini, 5, Naples, 80131, Italy. filomena.morisco@unina.it.
authors.forename: Filomena
authors.initials: F
authors.lastname: Morisco
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", Via S. Pansini, 5, Naples, 80131, Italy. maria.guarino86@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Guarino
authors.affiliation: Dermatology Units, University of Naples "Federico II", Via S. Pansini, 5, Naples, 80131, Italy. serena.labella@yahoo.it.
authors.forename: Serena
authors.initials: S
authors.lastname: La Bella
authors.affiliation: Dermatology Units, University of Naples "Federico II", Via S. Pansini, 5, Naples, 80131, Italy. luisadicostanzo@virgilio.it.
authors.forename: Luisa
authors.initials: L
authors.lastname: Di Costanzo
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", Via S. Pansini, 5, Naples, 80131, Italy. nicola.caporaso@unina.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Caporaso
authors.affiliation: Dermatology Units, University of Naples "Federico II", Via S. Pansini, 5, Naples, 80131, Italy. ayala@unina.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ayala
authors.affiliation: Dermatology Units, University of Naples "Federico II", Via S. Pansini, 5, Naples, 80131, Italy. balato@unina.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Balato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016174:Hepacivirus / Q000502:physiology*; D006509:Hepatitis B / Q000276:immunology / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000276:immunology / Q000821:virology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000821:virology*; D012189:Retrospective Studies; D014775:Virus Activation; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents