Background

The increasing use of biologics is accompanied by a risk of hepatitis B (HBV) and C virus (HCV) reactivation.

Objective

To determine the predictors of HBV and HCV reactivation in patients with psoriasis receiving biologics.

Methods

This study screened 2060 patients with psoriasis (3562 treatment episodes) who were taking biologics from 2009 to 2018. There were 359 patients with psoriasis with HBV (561 treatment episodes) and 61 with HCV infection (112 treatment episodes).

Results

During 8809 and 1522 person-months of follow-up, 88 treatment episodes for HBV involved HBV reactivation, and 14 episodes of HCV involved reactivation. The reactivation rate was significantly higher in treatment episodes of chronic HBV infection than in that of occult HBV (34.3% vs 3.2%, P = .001) and resolved HBV (34.3% vs 5.0%, P < .001). The multivariate analysis revealed that being hepatitis B surface antigen seropositive, being hepatitis B e-antigen seropositive, and tumor necrosis factor-α–inhibitor therapy were risk factors for HBV reactivation, whereas antiviral prophylaxis was effective in reducing the risk of HBV reactivation. No predictors were significantly associated with HCV reactivation.

Limitations

Observational design and a lack of a comparison group.

Conclusion

Patients with psoriasis on biologics have a risk of HBV and HCV reactivations, particularly those who are seropositive for hepatitis B surface antigen and hepatitis B e-antigen and undergoing tumor necrosis factor-α–inhibitor therapy.

中文翻译：

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使用生物制剂治疗的银屑病患者乙型和丙型肝炎病毒再激活的预测因素：一项为期 9 年的多中心队列研究

背景

越来越多地使用生物制剂伴随着乙型肝炎 (HBV) 和丙型肝炎病毒 (HCV) 重新激活的风险。

客观的

确定接受生物制剂治疗的银屑病患者 HBV 和 HCV 再激活的预测因素。

方法

本研究筛选了 2060 名 2009 年至 2018 年期间服用生物制剂的银屑病患者（3562 次治疗）。其中 359 名银屑病患者 HBV（561 次治疗）和 61 名 HCV 感染患者（112 次治疗）。

结果

在 8809 和 1522 人月的随访期间，88 次 HBV 治疗发作涉及 HBV 再激活，14 次 HCV 发作涉及再激活。慢性 HBV 感染治疗期间的再激活率显着高于隐匿性 HBV（34.3% 对 3.2%，P  = .001）和已消退的 HBV（34.3% 对 5.0%，P  < .001）。多变量分析显示，乙肝表面抗原血清阳性、乙肝 e 抗原血清阳性和肿瘤坏死因子-α-抑制剂治疗是 HBV 再激活的危险因素，而抗病毒预防可有效降低 HBV 再激活的风险。没有预测因子与 HCV 再激活显着相关。

限制

观察性设计且缺乏对照组。

结论

使用生物制剂治疗的银屑病患者有 HBV 和 HCV 再激活的风险，尤其是那些乙型肝炎表面抗原和乙型肝炎 e 抗原呈血清阳性并正在接受肿瘤坏死因子-α-抑制剂治疗的患者。