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首页> 外文期刊>The Journal of dermatology >Use of anti-tumor necrosis factor-α therapy in hepatitis B virus carriers with psoriasis or psoriatic arthritis: A case series in Taiwan
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Use of anti-tumor necrosis factor-α therapy in hepatitis B virus carriers with psoriasis or psoriatic arthritis: A case series in Taiwan

机译：抗肿瘤坏死因子-α疗法在银屑病或牛皮癣关节炎的乙型肝炎病毒携带者中的应用：台湾的一个病例系列

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摘要

The use of anti-tumor necrosis factor (TNF)-α therapy in patients with psoriasis who are hepatitis B virus (HBV) carriers is usually not recommended, and routine antiviral prophylaxis is suggested for those who need the treatment. We report our experience on the safety of anti-TNF-α therapy in patients with psoriasis who are HBV carriers in our clinic using HBV viral load as a guide for HBV treatment. Between 2007 and 2011, seven HBV carriers receiving TNF-α inhibitors for psoriasis in our clinic were collected retrospectively. The HBV viral load and aminotransferase levels were regularly monitored. Two of the seven patients were inactive HBV carriers, and the other five patients had chronic hepatitis B. Only one patient received antiviral agents before the anti-TNF-α treatment. The mean duration of the anti-TNF-α treatment was 26.6 months (range, 14-45 months). These patients were followed up from the start of the anti-TNF-α therapy for a mean duration of 28.9 months (range, 14-45 months). HBV reactivation was observed in three patients, one of whom required antiviral treatment. No HBV reactivation-related hepatitis was observed. In conclusion, prevention of HBV reactivation by monitoring of HBV viral load is cost-effective and may decrease the risk of developing drug resistance from routine anti-HBV prophylaxis treatment. It can be considered as an alternative in psoriasis patients treated by TNF-α inhibitors, especially in areas with a high HBV burden and in hepatitis B e-antigen-negative patients who have a lower risk of viral reactivation.
机译：通常不建议在乙型肝炎病毒（HBV）携带者的牛皮癣患者中使用抗肿瘤坏死因子（TNF）-α治疗，建议对需要该治疗的患者进行常规抗病毒治疗。我们在我们的诊所中报告了我们的经验，即使用HBV病毒载量作为HBV治疗指南的HBV携带者的牛皮癣患者抗TNF-α治疗的安全性。在2007年至2011年之间，我们诊所共收集了7例接受TNF-α抑制剂治疗牛皮癣的HBV携带者。定期监测HBV病毒载量和转氨酶水平。 7名患者中有2名是无效的HBV携带者，其他5名患者患有慢性乙型肝炎。在抗TNF-α治疗之前，只有1名患者接受了抗病毒药物。抗TNF-α治疗的平均持续时间为26.6个月（范围14-45个月）。从抗TNF-α治疗开始对这些患者进行随访，平均持续时间为28.9个月（范围为14-45个月）。在三名患者中观察到HBV激活，其中一名需要抗病毒治疗。没有观察到与HBV活化有关的肝炎。总之，通过监测HBV病毒载量来预防HBV活化具有成本效益，并可降低常规抗HBV预防治疗产生耐药性的风险。在使用TNF-α抑制剂治疗的牛皮癣患者中，尤其是在HBV负担高的地区以及病毒再激活风险较低的B型肝炎e抗原阴性患者中，它可以被视为替代药物。

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