Fulminant hepatic failure in chronic hepatitis B on withdrawal of corticosteroids, azathioprine and infliximab for Crohnʼs disease

Colbert, Carmelita; Chavarria, Arturo; Berkelhammer, Charles

doi:10.1002/ibd.20216

Cited by 54 publications

(41 citation statements)

References 8 publications

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“…[25][26][27][28][29][30] Table 3 presents a summary of studies reporting reactivation of HBV after infliximab, specifically in patients with IBD (CD in all cases). 7,[31][32][33][34][35][36][37][38] Cases of reactivation after treatment with infliximab have been described in occult carriers of HBV who are negative for HBsAg and positive for anti-HBc antibody 37 (see occult HBV infection, below). Reactivation of HBV infection in HBsAg carriers occurred as soon as after the HBsAg, hepatitis B surface antigen.…”

Section: Which Ibd Patients Should Be Screened For Prior Hbv ⁄ Hcv Exmentioning

confidence: 99%

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Gisbert

Chaparro

Esteve

2011

Alimentary Pharmacology &Amp; Therapeutics

105

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Section: Which Ibd Patients Should Be Screened For Prior Hbv ⁄ Hcv Exmentioning

confidence: 99%

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Gisbert

Chaparro

Esteve

2011

Alimentary Pharmacology &Amp; Therapeutics

105

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“…Hepatic manifestations are the predominant symptoms, including hepatitis or jaundice with elevated AST, ALT, alkaline phosphatase (ALP), γ-glutamyl transpeptidase and total bilirubin. New onset ascites, presenting as severe hepatitis with ballooning degeneration, hepatocyte necrosis and fibrosis on biopsy was detected in one case (170). Liver dysfunction, with moderate infiltration of chronic inflammatory cells and mild fibrosis in the portal area, occurred in another patient (168).…”

Section: Viral Infections Hepatitis B Virus Reactivationmentioning

confidence: 97%

“…Among patients who have received immunosuppressants, the rate of liver dysfunction was higher among HBsAg-positive patients than among HBsAgnegative ones (166). HBV reactivation in IBD patients treated with IFX is described in several patients in Table 4 (167)(168)(169)(170)(171)(172)(173)(174).…”

Section: Viral Infections Hepatitis B Virus Reactivationmentioning

confidence: 99%

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Risk of Infections of Biological Therapies with Accent on Inflammatory Bowel Disease

2014

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Background: Biological therapies using anti-tumor necrosis factor (TNF)-α agents have an important impact in the treatment of inflammatory bowel disease, rheumatoid arthritis, psoriasis, and other inflammatory conditions. However, a significant number of patients lose their response to these medications over time. Clinical trials have demonstrated that antibodies against anti-TNF agents may impact treatment response and increase the risk of infusion reactions. Of concern is also the possibility of developing adverse events induced by anti-TNF agents. The purpose of the present systematic review is to describe the current knowledge on the risk of infections associated with anti-TNF agents antagonists, as well as integrin antagonists. We also intend to describe case reports of these adverse events in inflammatory bowel disease patients. Methods: Currently approved anti-TNF biologicals in IBD include the monoclonal antibodies infliximab, adalimumab, certolizumab pegol and golimumab. Integrin antagonists include natalizumab, etrolizumab and vedolizumab. Results: The most frequently-reported adverse events of these biologicals were infections, and these are described in detail in this study. Discussion: Most adverse events are due to the failure of host immunological control, which involves de novo infection, or reactivation of latent bacterial or viral infection, often with a different expression of disease. Conclusion: Risk assessment in individuals undergoing treatment with biologicals represents a step towards achieving treatment personalization to identify those patients that will safely benefit from this therapeutic approach. Patients and physicians must be alert for anti-TNF agents and anti-integrin medication as potential causes of drug-induced infections and monitor the therapies. Personalizing therapeutic vigilance promises to optimize benefits while minimizing infections.This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

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“…Although the findings indicate that the risk of hepatitis reactivation mostly relies on the prednisone doses, as some cases of HBV reactivation have occurred with lowdoseprednisone therapies, caution is advisable [60] . In IBD there have also been reports of reactivation in patients under corticosteroids, with or without azathioprine or antiTNF therapy, even resulting in severe acute hepatitis [6,64,65] . The Spanish REPENTINA study describes 6 cases of HBV reactivation in IBD patients during conventional immunosuppressive therapy, two of them with prednisone in monotherapy.…”

Section: Hbv Reactivations In Patients With Inflammatory Diseasesmentioning

confidence: 99%

Hepatitis B and immunosuppressive therapies for chronic inflammatory diseases: When and how to apply prophylaxis, with a special focus on corticosteroid therapy

López-Serrano

Briongos

Alonso

et al. 2015

WJH

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Currently immunosuppressive and biological agents are used in a more extensive and earlier way in patients with inflammatory bowel disease, rheumatic or dermatologic diseases. Although these drugs have shown a significant clinical benefit, the safety of these treatments is a challenge. Hepatitis B virus (HBV) reactivations have been reported widely, even including liver failure and death, and it represents a deep concern in these patients. Current guidelines recommend to preemptive therapy in patients with immunosuppressants in general, but preventive measures focused in patients with corticosteroids and inflammatory diseases are scarce. Screening for HBV infection should be done at diagnosis. The patients who test positive for hepatitis B surface antigen, but do not meet criteria for antiviral treatment must receive prophylaxis before undergoing immunosuppression, including corticosteroids at higher doses than prednisone 20 mg/d during more than two weeks. Tenofovir and entecavir are preferred than lamivudine because of their better resistance profile in long-term immunosuppressant treatments. There is not a strong evidence, to make a general recommendation on the necessity of prophylaxis therapy in patients with inflammatory diseases that are taking low doses of corticosteroids in short term basis or low systemic bioavailability corticosteroids such as budesonide or beclomethasone dipropionate. In these cases regularly HBV DNA monitoring is recommended, starting early antiviral therapy if DNA levels begin to rise. In patients with occult or resolved hepatitis the risk of reactivation is much lower, and excepting for Rituximab treatment, the prophylaxis is not necessary. Hepatitis B and immunosuppressive therapies for chronic inflammatory diseases: When and how to apply prophylaxis, with a special focus on corticosteroid therapyCore tip: Few reviews have been published including data of the three more common inflammatory diseases that require immunosuppressive therapy: inflammatory bowel disease, rheumatic and dermatologic diseases. This paper is focused on the risk of reactivation of hepatitis B virus under immunosuppressants, and particularly corticosteroids. Although most of the guidelines do not specify the necessity of prophylaxis in case of monotherapy with corticosteroids, the specialists responsible of these patients are usually concerned about this issue. Moreover, the risk with low systemic bioavailability new corticosteroids has not been evaluated in previous reviews. This work summarizes the evidence of VHB reactivation in patients with inflammatory diseases: when and how to apply prophylaxis, with a special focus on "new" and "old" steroids.López-Serrano P, de la Fuente Briongos E, Carrera-Alonso E, Pérez-Calle JL, Fernández Rodríguez C. Hepatitis B and immunosuppressive therapies for chronic inflammatory diseases: When and how to apply prophylaxis, with a special focus on corticosteroid therapy.

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Fulminant hepatic failure in chronic hepatitis B on withdrawal of corticosteroids, azathioprine and infliximab for Crohnʼs disease

Cited by 54 publications

References 8 publications

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Risk of Infections of Biological Therapies with Accent on Inflammatory Bowel Disease

Hepatitis B and immunosuppressive therapies for chronic inflammatory diseases: When and how to apply prophylaxis, with a special focus on corticosteroid therapy

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