Reactivation of Hepatitis B Virus Following Anti-Tumor Necrosis Factor-alpha Therapy

ABSTRACT

Anti-tumor necrosis factor (TNF)-alpha therapy is being increasingly used to treat several rheumatic diseases and inflammatory bowel diseases. However, treatment with anti-TNF-alpha therapy of patients with a concurrent hepatitis B virus (HBV) or hepatitis C virus (HCV) infection can promote viral reactivation and potentially fatal liver failure. The medical records of 176 patients who had been treated with an anti-TNF-alpha therapy at single center from January 2010 to December 2012 were retrospectively analyzed. Of the 176 patients, the hepatitis B surface antigen (HBsAg) status of 114 (64.8%) were tested at the baseline. Five (4.4%) of them were HBsAg-positive, and 109 (95.6%) were negative. Only 10 of the HBsAg-negative patients (9.2%) were checked for hepatitis B core antigen. Ninety-one patients were checked for anti-HCV, and two (2.2%) were positive. After their anti-TNF-alpha therapy, HBV reactivation was confirmed in two patients. The reactivation of HBV after the anti-TNF-alpha therapy was observed in the HBsAg-positive patients.