Safety of tumor necrosis factor α blockers in hepatitis B virus occult carriers (hepatitis B surface antigen negative/anti–hepatitis B core antigen positive) with rheumatic diseases

• DOI: 10.1002/acr.20130
• Publication Date: 2010-02-12T17:50:39Z
• Authors: R. Caporali; F. Bobbio‐Pallavi...; F. Atzeni; G. Sakellariou; M. Caprioli; C. Montecucco; P. Sarzi‐Puttini
• Keywords: Hepatitis B; Outpatient clinic

To assess the safety of anti-tumor necrosis factor alpha (anti-TNFalpha) therapy on course hepatitis B virus (HBV) infection in carriers antibodies to core antigen (anti-HBc) affected by chronic inflammatory arthropathies.From January 2001 December 2008, HBV markers were determined before first administration anti-TNFalpha agents all 732 patients arthropathies treated with at 2 outpatient rheumatologic clinics Northern Italy. Anti-HBc-positive prospectively evaluated and DNA assessed every 6 months, case aminotransferase elevation, end study.At time recruitment, 72 anti-HBc carriers, 5 whom positive for surface (HBsAg) not included study. The ratio men:women was 26:41 mean +/- SD followup 42.52 21.33 months. Of patients, 25 infliximab, 23 etanercept, 19 adalimumab. Fifty-one also methotrexate, 52 nonsteroidal antiinflammatory drugs, 43 prednisone (3 a dosage >7.5 mg/day). All negative observation. During followup, no patient presented reactivation viral load increase became HBsAg positive.Anti-HBc positivity HBsAg-negative is sign previous does indicate hepatitis. In these appears be quite safe, as found our Nevertheless, careful monitoring necessary.