Safety of anti-TNF alpha treatment in rheumatic patients with chronic hepatitis B or C


Authors: O. Šléglová;  Z. Mareček 1;  P. Urbánek 1;  K. Pavelka
Authors‘ workplace: Revmatologický ústav Praha ;  Interní klinika ILF UK a ÚVN Praha 1
Published in: Čes. Revmatol., 15, 2007, No. 2, p. 105-111.
Category: Overview Reports

Overview

Administration of tumor necrosis factor alpha inhibitors (anti-TNF alpha) represents an immense progress in the treatment of inflammatory rheumatic diseases. However, it associates with increased risk of infections. The authors emphasize the possibilities of hepatitis B virus reactivation during anti-TNF alpha treatment, which caused serious complications in several cases. Therefore screening for hepatitis B before the initiation of the treatment is necessary. Anti-TNF alpha treatment could be safe in patients with chronic hepatitis B, when treatment with lamivudin or adefovir prior to anti-TNF alpha is started. Careful monitoring of liver enzymes and viraemia during this treatment is necessary. Different situation is in patients with hepatitis C. Anti-TNF alpha treatment is safe in patients with chronic hepatitis C, however screening for hepatitides, and careful monitoring of liver enzymes and viraemia during the treatment is also necessary. One of the presented study shows that combination of standard antiviral treatment of hepatitis C and anti-TNF alpha may increase the chance to suppress viral replication early. More vigilance is necessary to the issue of anti-TNF alpha treatment of patients with hepatitis B or C and further studies on coincidence of those diseases are anticipated.

Key words:
anti-TNF alpha treatment, hepatitis B, hepatitis C, inflammatory rheumatic diseases


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Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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