Conflicts of interest: None.
Pharmacology and Therapeutics
Outcome of patients with serology suggestive of past hepatitis B virus infection during antitumor necrosis factor therapy for psoriasis
Article first published online: 14 FEB 2014
© 2014 The International Society of Dermatology
International Journal of Dermatology
Volume 53, Issue 7, pages 909–911, July 2014
How to Cite
Navarro, R., Concha-Garzón, M. J., Castaño, C., Casal, C., Guiu, A. and Daudén, E. (2014), Outcome of patients with serology suggestive of past hepatitis B virus infection during antitumor necrosis factor therapy for psoriasis. International Journal of Dermatology, 53: 909–911. doi: 10.1111/ijd.12313
- Issue published online: 19 JUN 2014
- Article first published online: 14 FEB 2014
Recently, the reactivation during treatment with tumor necrosis factor (TNF) blockers has exceptionally been described in patients with hepatitis B virus (HBV) antigen-negative (HBsAg). The objective was to evaluate the influence of anti-TNF agents in patients with psoriasis and serology suggesting past hepatitis B state.
The inclusion criteria were chronic plaque psoriasis treated with anti-TNF therapy, HBsAg-negative, and HBcAb-positive. We gathered the demographic data and type and duration of anti-TNF agent. Serum aminotransferase levels and HBV serologic status were requested at baseline and during follow-up.
We have included 13 patients (four women, nine men) (mean age of 62.1 years). The agent was etanercept in seven cases, infliximab in four patients, and adalimumab in the other two. The mean duration of TNF therapy was 28.6 months. None of them became HBsAg-positive. Neither signs nor symptoms of acute hepatitis were reported.
The management of HBsAg-negative patients is unresolved. Only nine cases of HBV reactivation during treatment with TNF blockers have been reported. Despite the low risk of reactivation in these patients, we recommend the monitoring of serum aminotransferase levels, HBsAb titers, HBsAg and, if possible, viral load.