RESUMO
Anti-TNF-α agents have emerged as a potent treatment for patients with rheumatoid arthritis unresponsive to conventional disease-modifying antirheumatic drugs. Increased susceptibility to infections induced by these drugs is the main complication of their use. Reactivation of hepatitis B virus (HBV) is one of the most worrisome side effects in patients with HBV infection receiving anti-TNF-α. We report the case of a 56-year-old male patient with stable hepatitis B and good response to the antiviral combination of lamivudine and tenofovir when infliximab was started. The patient went into remission. During the 30-month treatment with the biologic, his liver function remained stable, with no HBV reactivation.
Assuntos
Anticorpos Monoclonais/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Hepatite B Crônica/complicações , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Anticorpos Monoclonais/efeitos adversos , Antirreumáticos/efeitos adversos , Humanos , Infliximab , Masculino , Pessoa de Meia-IdadeRESUMO
Os agentes anti-TNF-α emergiram como potente tratamento para os pacientes com artrite reumatoide que não respondem às drogas modificadoras de doença convencionais. Por induzir à imunossupressão, essas drogas têm como principal complicação o aumento da suscetibilidade a várias infecções. A reativação do vírus da hepatite B (HBV) é um dos efeitos colaterais mais preocupantes em pacientes recebendo agentes anti-TNF-α com infecção pelo HBV. Descrevemos o caso de um paciente de 56 anos com quadro de hepatite B estável, com boa resposta à associação dos antivirais lamivudina e tenofovir quando iniciou infliximabe. O paciente obteve boa resposta ao anti-TNF-α , atingindo remissão da doença. Durante os 30 meses de tratamento com o biológico, manteve função hepática estável, sem reativação do HBV.
Anti-TNF-α agents have emerged as a potent treatment for patients with rheumatoid arthritis unresponsive to conventional disease-modifying antirheumatic drugs. Increased susceptibility to infections induced by these drugs is the main complication of their use. Reactivation of hepatitis B virus (HBV) is one of the most worrisome side effects in patients with HBV infection receiving anti-TNF-α. We report the case of a 56-year-old male patient with stable hepatitis B and good response to the antiviral combination of lamivudine and tenofovir when infliximab was started. The patient went into remission. During the 30-month treatment with the biologic, his liver function remained stable, with no HBV reactivation.