Patients with core antibody positive and surface antigen negative Hepatitis B (anti-HBc+, HBsAg-) on anti-TNF therapy have a low rate of reactivation.
Anti-TNF agents are widely used to treat immune-mediated disorders. Reactivation of Hepatitis B virus (HBV) is associated with immunosuppressive agents and biologics such as anti-TNF. There are limited data and differing guidelines for patients with negative hepatitis B surface antigen (HBsAg-) but positive antibody to hepatitis B core antigen (anti-HBc+) on anti-TNF with regards to outcomes and need for anti-viral prophylaxis. We examined the prevalence of HBV reactivation in a single-center retrospective cohort study of 120 HBsAg-, anti-HBc+ patients on anti-TNF, totaling 346.6 patient years. One patient (0.8%) who had a detectable VL (<20 IU) prior to starting anti-TNF had reactivation of HBV with sero-conversion to positive HBsAg. Three patients (2.5%) had undetectable HBV VL prior to anti-TNF and developed detectable VL while on anti-TNF. In conclusion, there was a low rate of HBV reactivation or development of detectable HBV DNA in HBsAg-, anti-HBc+ patients on anti-TNF.
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Related Subject Headings
- Virus Activation
- Tumor Necrosis Factor-alpha
- Middle Aged
- Male
- Immunology
- Humans
- Hepatitis B virus
- Hepatitis B Surface Antigens
- Hepatitis B Core Antigens
- Hepatitis B Antibodies
Citation
Published In
DOI
EISSN
Publication Date
Volume
Start / End Page
Location
Related Subject Headings
- Virus Activation
- Tumor Necrosis Factor-alpha
- Middle Aged
- Male
- Immunology
- Humans
- Hepatitis B virus
- Hepatitis B Surface Antigens
- Hepatitis B Core Antigens
- Hepatitis B Antibodies