Funding sources: None.
Is universal screening for hepatitis C infection prior to commencing antitumour necrosis factor-α therapy necessary?
Article first published online: 2 DEC 2013
© 2013 British Association of Dermatologists
British Journal of Dermatology
Volume 169, Issue 6, pages 1319–1321, December 2013
How to Cite
Reid, C.T., De Gascun, C., Hall, W., Collins, P., Lally, A. and Kirby, B. (2013), Is universal screening for hepatitis C infection prior to commencing antitumour necrosis factor-α therapy necessary?. British Journal of Dermatology, 169: 1319–1321. doi: 10.1111/bjd.12598
Conflicts of interest: B.K. is in receipt of unrestricted research grants from Abbott Ltd, Pfizer and Janssen, and works as an advisor to and consultant for Abbott Ltd, Pfizer and Janssen.
- Issue published online: 2 DEC 2013
- Article first published online: 2 DEC 2013
- Accepted manuscript online: 21 AUG 2013 02:40AM EST
- Manuscript Accepted: 17 AUG 2013
Screening for hepatitis C virus (HCV) prior to the commencement of antitumour necrosis factor (anti-TNF)-α therapies for dermatological disease is recommended for all patients.
To determine the incidence of HCV infection among dermatology patients who were screened for HCV infection prior to commencing anti-TNF-α therapies.
We reviewed the HCV infection status of all patients attending our dermatology department who had been tested for evidence of HCV infection between January 2005 and November 2012. We identified patients who had been tested as part of routine screening prior to commencing anti-TNF-α therapy using dermatology departmental records.
In total, 215 patients were screened for HCV infection prior to commencing anti-TNF-α therapies. Among this group, 143 patients (66·5%) were male and 72 (33·5%) were female. None of these patients tested positive for active HCV infection. One patient tested positive for HCV antibody with negative HCV antigen and HCV RNA. This indicated previous HCV infection that had cleared. This patient had abnormal liver function tests and a history of alcohol excess.
There were no cases of active HCV infection diagnosed through pretreatment anti-TNF-α screening in our department, which is located in a low-prevalence area for HCV infection. In view of the lack of evidence of harm associated with anti-TNF-α use in HCV-infected patients, we propose that screening for HCV infection in low-prevalence areas should be targeted to those with pre-existing risk factors. This is consistent with current guidelines from the Royal College of General Practitioners. Targeted screening rather than universal screening may be a safe and cost-effective option among patients being evaluated for anti-TNF-α therapies.