title: Risk of hepatitis B virus reactivation in rheumatoid arthritis patients undergoing biologic treatment: Extending perspective from old to newer drugs.
abstract: Hepatitis B virus (HBV) reactivation in rheumatoid arthritis (RA) patients undergoing biological therapy is not infrequent. This condition can occur in patients with chronic hepatitis B as well as in patients with resolved HBV infection. Current recommendations are mainly focused on prevention and management strategies of viral reactivation under tumor necrosis factor-α inhibitors or chimeric monoclonal antibody rituximab. In recent years, growing data concerning HBV reactivation in RA patients treated with newer biological drugs like tocilizumab and abatacept have cumulated. In this review, epidemiology, pathogenesis and natural history of HBV infection have been revised first, mainly focusing on the role that specific therapeutic targets of current biotechnological drugs play in HBV pathobiology; finally we have summarized current evidences from scientific literature, including either observational studies and case reports as well, concerning HBV reactivation under different classes of biological drugs in RA patients. Taking all these evidences into account, some practical guidelines for screening, vaccination, prophylaxis and treatment of HBV reactivation have been proposed.
authors.affiliation: Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali, IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia, 27100 Pavia, Italy.
authors.forename: Francesca De
authors.initials: FD
authors.lastname: Nard
authors.affiliation: Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali, IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia, 27100 Pavia, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Todoerti
authors.affiliation: Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali, IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia, 27100 Pavia, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Grosso
authors.affiliation: Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali, IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia, 27100 Pavia, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Monti
authors.affiliation: Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali, IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia, 27100 Pavia, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Breda
authors.affiliation: Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali, IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia, 27100 Pavia, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Rossi
authors.affiliation: Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali, IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia, 27100 Pavia, Italy.
authors.forename: Carlomaurizio
authors.initials: C
authors.lastname: Montecucco
authors.affiliation: Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali, IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia, 27100 Pavia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Caporali
keywords: Abatacept; Anti-TNF; Biologics; Hepatitis B virus; Rheumatoid arthritis; Rituximab; Tocilizumab
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