Hsien-Yi Chiu1, Ying-Ming Chiu2, Nien-Feng Chang Liao3, Ching-Chi Chi4, Tsen-Fang Tsai5, Chang-Yu Hsieh6, Tsu-Yi Hsieh7, Kuo-Lung Lai8, Tsu-Man Chiu9, Nan-Lin Wu10, Rosaline Chung-Yee Hui11, Chaw-Ning Lee12, Ting-Shun Wang13, Po-Hua Chen14, Chao-Chun Yang12, Yu-Huei Huang15. 1. Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan; Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan. 2. Department of Allergy, Immunology, and Rheumatology, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan. 3. Department of Dermatology, China Medical University Hospital, Taichung, Taiwan. 4. Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 5. Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan; Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan. 6. Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan. 7. Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan; Ph.D. Program of Business, Feng Chia University, Taichung, Taiwan. 8. Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 9. Department of Dermatology, Changhua Christian Hospital, Changhua, Taiwan; Institute of Biochemistry, Microbiology, Immunology, Chung Shan Medical University, Taichung, Taiwan; Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan. 10. Department of Medicine, Mackay Medical College, New Taipei, Taiwan; Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, New Taipei, Taiwan. 11. Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Taiwan; Department of Dermatology, Chang Gung Memorial Hospital, Keelung, Taiwan. 12. Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 13. Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan; Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Dermatology, Chung Shan Medical University, Taichung, Taiwan. 14. Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan. 15. Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: huang3764@mail2000.com.tw.
Abstract
BACKGROUND: The increasing use of biologics is accompanied by a risk of hepatitis B (HBV) and C virus (HCV) reactivation. OBJECTIVE: To determine the predictors of HBV and HCV reactivation in patients with psoriasis receiving biologics. METHODS: This study screened 2060 patients with psoriasis (3562 treatment episodes) who were taking biologics from 2009 to 2018. There were 359 patients with psoriasis with HBV (561 treatment episodes) and 61 with HCV infection (112 treatment episodes). RESULTS: During 8809 and 1522 person-months of follow-up, 88 treatment episodes for HBV involved HBV reactivation, and 14 episodes of HCV involved reactivation. The reactivation rate was significantly higher in treatment episodes of chronic HBV infection than in that of occult HBV (34.3% vs 3.2%, P = .001) and resolved HBV (34.3% vs 5.0%, P < .001). The multivariate analysis revealed that being hepatitis B surface antigen seropositive, being hepatitis B e-antigen seropositive, and tumor necrosis factor-α-inhibitor therapy were risk factors for HBV reactivation, whereas antiviral prophylaxis was effective in reducing the risk of HBV reactivation. No predictors were significantly associated with HCV reactivation. LIMITATIONS: Observational design and a lack of a comparison group. CONCLUSION: Patients with psoriasis on biologics have a risk of HBV and HCV reactivations, particularly those who are seropositive for hepatitis B surface antigen and hepatitis B e-antigen and undergoing tumor necrosis factor-α-inhibitor therapy.
BACKGROUND: The increasing use of biologics is accompanied by a risk of hepatitis B (HBV) and C virus (HCV) reactivation. OBJECTIVE: To determine the predictors of HBV and HCV reactivation in patients with psoriasis receiving biologics. METHODS: This study screened 2060 patients with psoriasis (3562 treatment episodes) who were taking biologics from 2009 to 2018. There were 359 patients with psoriasis with HBV (561 treatment episodes) and 61 with HCV infection (112 treatment episodes). RESULTS: During 8809 and 1522 person-months of follow-up, 88 treatment episodes for HBV involved HBV reactivation, and 14 episodes of HCV involved reactivation. The reactivation rate was significantly higher in treatment episodes of chronic HBV infection than in that of occult HBV (34.3% vs 3.2%, P = .001) and resolved HBV (34.3% vs 5.0%, P < .001). The multivariate analysis revealed that being hepatitis B surface antigen seropositive, being hepatitis B e-antigen seropositive, and tumor necrosis factor-α-inhibitor therapy were risk factors for HBV reactivation, whereas antiviral prophylaxis was effective in reducing the risk of HBV reactivation. No predictors were significantly associated with HCV reactivation. LIMITATIONS: Observational design and a lack of a comparison group. CONCLUSION:Patients with psoriasis on biologics have a risk of HBV and HCV reactivations, particularly those who are seropositive for hepatitis B surface antigen and hepatitis B e-antigen and undergoing tumor necrosis factor-α-inhibitor therapy.
Authors: Julie J Hong; Edward K Hadeler; Megan L Mosca; Nicholas D Brownstone; Tina Bhutani; Wilson J Liao Journal: J Psoriasis Psoriatic Arthritis Date: 2022-01-12
Authors: Naomi Serling-Boyd; Amir M Mohareb; Arthur Y Kim; Emily P Hyle; Zachary S Wallace Journal: Ann Rheum Dis Date: 2020-07-30 Impact factor: 19.103