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.
J Am Acad Dermatol
; 77(1): 88-97.e5, 2017 Jul.
Article
en En
| MEDLINE
| ID: mdl-28495497
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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Psoriasis
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Activación Viral
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Productos Biológicos
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Virus de la Hepatitis B
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Hepatitis C
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Hepacivirus
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Hepatitis B
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
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Systematic_reviews
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Am Acad Dermatol
Año:
2017
Tipo del documento:
Article