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.

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。