Kiran Motaparthi1, Vladimir Stanisic1, Abby S Van Voorhees2, Mark G Lebwohl3, Sylvia Hsu4. 1. Department of Dermatology, Baylor College of Medicine, Houston, Texas. 2. University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. 3. Mount Sinai School of Medicine, New York, New York. 4. Department of Dermatology, Baylor College of Medicine, Houston, Texas. Electronic address: shsu@bcm.edu.
Abstract
BACKGROUND: No consensus exists regarding the optimal laboratory screening for hepatitis B infection that should be performed before initiating therapy with tumor necrosis factor-alfa inhibitors or other immunosuppressive agents. OBJECTIVE: We sought to give guidelines on which tests to order for hepatitis B screening. METHODS: We review the pathophysiology and serology of hepatitis B infection and provide recommendations for screening for hepatitis B infection in patients with psoriasis before beginning anti-tumor necrosis factor-alfa therapy or other immunosuppressive agents. RESULTS: We propose the standardized use of triple serology testing: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody in combination with liver function tests as screening. LIMITATIONS: Conclusions based on review of available literature is a limitation. CONCLUSIONS: All patients with psoriasis who are candidates for tumor necrosis factor-alfa inhibitor should undergo screening for hepatitis B virus infection using the triple serology: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. It is advisable that patients, who are candidates for ustekinumab, cyclosporine, or methotrexate undergo the same screening.
BACKGROUND: No consensus exists regarding the optimal laboratory screening for hepatitis B infection that should be performed before initiating therapy with tumor necrosis factor-alfa inhibitors or other immunosuppressive agents. OBJECTIVE: We sought to give guidelines on which tests to order for hepatitis B screening. METHODS: We review the pathophysiology and serology of hepatitis B infection and provide recommendations for screening for hepatitis B infection in patients with psoriasis before beginning anti-tumor necrosis factor-alfa therapy or other immunosuppressive agents. RESULTS: We propose the standardized use of triple serology testing: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody in combination with liver function tests as screening. LIMITATIONS: Conclusions based on review of available literature is a limitation. CONCLUSIONS: All patients with psoriasis who are candidates for tumor necrosis factor-alfa inhibitor should undergo screening for hepatitis B virus infection using the triple serology: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. It is advisable that patients, who are candidates for ustekinumab, cyclosporine, or methotrexate undergo the same screening.
Authors: Junko Takeshita; Sungat Grewal; Sinéad M Langan; Nehal N Mehta; Alexis Ogdie; Abby S Van Voorhees; Joel M Gelfand Journal: J Am Acad Dermatol Date: 2017-03 Impact factor: 11.527
Authors: Marco Fiore; Sebastiano Leone; Alberto Enrico Maraolo; Emilio Berti; Giovanni Damiani Journal: Biomed Res Int Date: 2018-02-06 Impact factor: 3.411