Hepatitis B reactivation in a chronic hepatitis B surface antigen carrier with rheumatoid arthritis treated with infliximab and low dose methotrexate

Abstract

Swollen joint count 9.9 (6.8) 5.8 (7.5)* 2.3 (4.6)* PASI (psoriasis activity skin index) 12.1 (10.3) 1.7 (5.6)* 1.1 (2.7)* ESR (mm/1st h) 21.6 (15.5) 15.9 (9.4) 20.2 (20.4) CRP (mg/l) 0.9 (0.9) 0.7 (1.3) 0.2 (0.4)* *p<0.01 as compared with baseline (determined by t test for paired data).

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

“…Reactivation of HBV infection related to infliximab has been reported in a number of patients with diseases other than IBD. [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).…”

Administration of Methotrexate in Rheumatoid Arthritis Patients with Chronic Hepatitis B

“…7,8,9 Retrospective studies have recommended prophylaxis therapy using lamivudine to prevent HBV reactivation in RA patients who received immunosuppressive therapy. Prospective study by Tamori et Meanwhile, study by Mori concluded that DMARD was relatively safe to be given in most RA patients with HBV infection history although anti HBV prophylaxis was not given.…”

Biological Therapy and Infection in Rheumatoid Arthritis Patients: Modern Aspects

“…По данным литературы последних 5 лет, частота HBV-носительства среди больных РА и спондило-артропатиями колеблется от 10 до 66% [67][68][69][70][71][72]. С другой стороны, случаи реактивации HBV-инфекции описаны для всех ГИБП, включая развитие фульминантного гепа-тита у больных РА и болезнью Стилла на фоне терапии ИНФ [73,74]. Японскими исследователями установлено, что назначение ГИБП больным РА, являющимся HBV-носителями, повышало вероятность активации инфекции в 10,9 раза (р=0,008) [69].…”