Patients with core antibody positive and surface antigen negative Hepatitis B (anti-HBc+, HBsAg-) on anti-TNF therapy have a low rate of reactivation.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Clarke, WT; Amin, SS; Papamichael, K; Feuerstein, JD; Cheifetz, AS

Published Date

  • June 2018

Published In

Volume / Issue

  • 191 /

Start / End Page

  • 59 - 62

PubMed ID

  • 29601854

Electronic International Standard Serial Number (EISSN)

  • 1521-7035

Digital Object Identifier (DOI)

  • 10.1016/j.clim.2018.03.013


  • eng

Conference Location

  • United States