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Patients with core antibody positive and surface antigen negative Hepatitis B (anti-HBc+, HBsAg−) on anti-TNF therapy have a low rate of reactivation
Clinical Immunology ( IF 4.5 ) Pub Date : 2018-03-28 , DOI: 10.1016/j.clim.2018.03.013
William T. Clarke , Shreya S. Amin , Konstantinos Papamichael , Joseph D. Feuerstein , Adam S. Cheifetz

Anti-TNF agents are widely used to treat immune-mediated disorders. Reactivation of Hepatitis B virus (HBV) is associated with immunosuppressive agents and biologics such as anti-TNF. There are limited data and differing guidelines for patients with negative hepatitis B surface antigen (HBsAg−) but positive antibody to hepatitis B core antigen (anti-HBc+) on anti-TNF with regards to outcomes and need for anti-viral prophylaxis. We examined the prevalence of HBV reactivation in a single-center retrospective cohort study of 120 HBsAg−, anti-HBc+ patients on anti-TNF, totaling 346.6 patient years. One patient (0.8%) who had a detectable VL (<20 IU) prior to starting anti-TNF had reactivation of HBV with sero-conversion to positive HBsAg. Three patients (2.5%) had undetectable HBV VL prior to anti-TNF and developed detectable VL while on anti-TNF. In conclusion, there was a low rate of HBV reactivation or development of detectable HBV DNA in HBsAg−, anti-HBc+ patients on anti-TNF.



中文翻译:

接受抗TNF治疗的核心抗体阳性和表面抗原阴性的乙型肝炎(抗HBc +,HBsAg−)的患者复活率低

抗TNF剂被广泛用于治疗免疫介导的疾病。乙型肝炎病毒(HBV)的重新激活与免疫抑制剂和生物制剂(例如抗TNF)有关。关于结局和抗病毒预防的需求,对于乙型肝炎表面抗原(HBsAg-)阴性但乙型肝炎核心抗原抗TNF抗体阳性的患者(anti-HBc +),数据有限且指南不同。我们在一项针对120名HBsAg-,抗-HBc +患者接受抗TNF的单中心回顾性队列研究中,共346.6患者年,检查了HBV激活的患病率。在开始抗TNF治疗之前有可检测的VL(<20 IU)的一名患者(0.8%)通过血清转化为阳性HBsAg而重新激活了HBV。三名患者(2.5%)在接受抗TNF治疗之前检测不到HBV VL,而接受抗TNF治疗则出现了可检测到的VL。

更新日期:2018-03-28
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