Risk for hepatitis B and C virus reactivation in patients with psoriasis on biologic therapies: A retrospective cohort study and systematic review of the literature - 14/12/17
Abstract |
Background |
Patients with psoriasis on biologic therapies and a history of viral hepatitis carry a risk for reactivation.
Objective |
We evaluated safety of biologic therapies in psoriasis patients seropositive for hepatitis B or C viruses (HBV, HCV).
Methods |
A retrospective cohort study design was used. Clinical and laboratory data for 30 patients undergoing biologic therapy who were seropositive for HBV or HCV were evaluated. Next, a systematic review was performed. Primary outcomes were hepatitis and viral reactivation during therapy. Treatment duration and antiviral prophylaxis were also recorded.
Results |
Serology indicated HCV infection in 4 patients, past HBV infection in 17 patients, isolated core antibody in 8 patients, and chronic HBV infection in 1 patient. During follow-up (mean 4.85 ± 3.1 years), no patients experienced hepatitis or viral reactivation. The systematic review of the literature included 49 studies comprising 312 patients followed for a mean of 30.9 months. Viral reactivation occurred in 2/175 patients who were seropositive for core antibody and 3/97 with HCV infection (yearly rates, 0.32% and 2.42%, respectively) compared with 8/40 patients with chronic HBV infection (yearly rate, 13.92%). Three of these 8 patients with reactivated HBV infection received antiviral prophylaxis.
Limitations |
We pooled heterogeneous studies evaluating different biologic therapies.
Conclusion |
Biologic therapies pose minimal risk for viral reactivation in low-risk patients without hepatitis seropositive for HCV or HBV core antibody but are a considerable risk in patients with chronic HBV infection, highlighting the necessity of antiviral prophylaxis.
Le texte complet de cet article est disponible en PDF.Key words : biologic, HBcAg, hepatitis B virus, hepatitis C virus, psoriasis, reactivation, risk
Abbreviations used : HBcAb, HBsAb, HBsAg, HBV, HCV, IL, OBI, PRISMA, TNF-α
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 77 - N° 1
P. 88 - juillet 2017 Retour au numéro
Article précédent
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