J Sanz-Bueno1, F Vanaclocha2, I García-Doval3, R Torrado4, G Carretero4, E Daudén5, D Patricia Ruiz-Genao6, M M Alsina-Gibert7, B Pérez-Zafrilla8, G Pérez-Rial9, R Rivera2. 1. Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: jsanzbueno@gmail.com. 2. Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España. 3. Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo y Unidad de Investigación, Vigo, España; Fundación de la Academia Española de Dermatología, Madrid, España. 4. Servicio de Dermatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España. 5. Servicio de Dermatología. Hospital Universitario La Princesa, Madrid, España. 6. Servicio de Dermatología, Hospital Fundación de Alcorcón, Alcorcón, Madrid, España. 7. Servicio de Dermatología, Hospital Clínic, Universitat de Barcelona, Barcelona, España. 8. Fundación de la Academia Española de Dermatología, Madrid, España; Unidad de Investigación, Complejo Hospitalario Universitario de Albacete, Albacete, España. 9. Servicio de Medicina del Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, España.
Abstract
INTRODUCTION AND OBJECTIVES: A 5% risk of reactivation of hepatitis B virus (HBV) infection has been reported in patients with diseases other than psoriasis treated with tumor necrosis factor inhibitors. The aim of this study was to investigate the risk of HBV reactivation in patients with a past history of HBV infection who were receiving biologic therapy for psoriasis. MATERIAL AND METHODS: This was a multicenter study of 20 patients with psoriasis who were treated with at least 1 biologic agent. All the patients had serologic evidence of past HBV infection (positive total hepatitis B core antibody and negative hepatitis B surface antibody). We analyzed the clinical, serological, and liver function variables recorded before, during, and at the end of follow-up. The viral load at the end of follow-up was also analyzed for all patients. RESULTS: None of the patients fulfilled the criteria for HBV reactivation at the end of a median follow-up period of 40 months. Combining our data with data from other studies of psoriasis patients with a past history of HBV infection who were treated with a biologic, we calculated a maximum estimated risk of HBV reactivation for a mean follow-up period of 30 months of 2.7 reactivations per 100 patients. CONCLUSIONS: Biologic therapy did not cause HBV reactivation in our series of patients. Nonetheless, because of the potentially serious complications associated with HBV reactivation, it is important to measure viral load in patients with a history of HBV infection prior to initiation of biologic therapy to rule out occult carriage. These patients should also be monitored regularly in conjunction with a hepatologist.
INTRODUCTION AND OBJECTIVES: A 5% risk of reactivation of hepatitis B virus (HBV) infection has been reported in patients with diseases other than psoriasis treated with tumor necrosis factor inhibitors. The aim of this study was to investigate the risk of HBV reactivation in patients with a past history of HBV infection who were receiving biologic therapy for psoriasis. MATERIAL AND METHODS: This was a multicenter study of 20 patients with psoriasis who were treated with at least 1 biologic agent. All the patients had serologic evidence of past HBV infection (positive total hepatitis B core antibody and negative hepatitis B surface antibody). We analyzed the clinical, serological, and liver function variables recorded before, during, and at the end of follow-up. The viral load at the end of follow-up was also analyzed for all patients. RESULTS: None of the patients fulfilled the criteria for HBV reactivation at the end of a median follow-up period of 40 months. Combining our data with data from other studies of psoriasispatients with a past history of HBV infection who were treated with a biologic, we calculated a maximum estimated risk of HBV reactivation for a mean follow-up period of 30 months of 2.7 reactivations per 100 patients. CONCLUSIONS: Biologic therapy did not cause HBV reactivation in our series of patients. Nonetheless, because of the potentially serious complications associated with HBV reactivation, it is important to measure viral load in patients with a history of HBV infection prior to initiation of biologic therapy to rule out occult carriage. These patients should also be monitored regularly in conjunction with a hepatologist.
Authors: Luigi Gargiulo; Giulia Pavia; Mario Valenti; Ana Lleo de Nalda; Chiara Perugini; Antonio Costanzo; Alessandra Narcisi Journal: Dermatol Ther (Heidelb) Date: 2022-04-22