title: Safety and efficacy of anti-tumor necrosis factors α in patients with psoriasis and chronic hepatitis C.
abstract: Up to date, in literature, it is still debated the role of anti-tumor necrosis factors (TNF)-α treatments in hepatitis C virus (HCV) patients. TNF-α performs a lot of functions, it is an important pro-inflammatory cytokine and it is involved in the host's immunity. Since TNF-α is implicated in the apoptotic signaling pathway of hepatocytes infected by HCV, anti TNF-α therapy may increase the risk of viral replication or their reactivation. However the treatment of anti TNF-α could have a healthful role because TNF-α appears to be engaged in the pathogenesis of liver fibrosis, inducing apoptotic pathways. We describe the case of a patient with plaque-type psoriasis and concomitant chronic HCV, who was treated successfully with anti-TNF agents simultaneously to cyclosporine without sign of reactivation of HCV and increase of liver enzymes. Our personal experience shows that anti-TNF-α agents are not only effective but also safe. Furthermore the combination therapy of cyclosporine and anti-TNF-α appears to be well-tolerated and able to reduce the amount of liver enzymes as well as HCV-viral-load. However systematic, large-scale studies with long follow-ups will be needed to confirm our results, in association with close liver function monitoring.
authors.affiliation: Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Salvi
authors.affiliation: Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Macaluso
authors.affiliation: Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Luci
authors.affiliation: Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Mattozzi
authors.affiliation: Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paolino
authors.affiliation: Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Aprea
authors.affiliation: Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Calvieri
authors.affiliation: Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Antonio Giovanni
authors.initials: AG
authors.lastname: Richetta
keywords: Anti-tumor necrosis factors-α agents; Cyclosporine; Hepatitis C virus infection; Psoriasis; Safety