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首页> 外文期刊>Expert opinion on biological therapy >The impact of biologic response modifiers on hepatitis B virus infection.
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The impact of biologic response modifiers on hepatitis B virus infection.

机译：生物反应调节剂对乙型肝炎病毒感染的影响。

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INTRODUCTION: The biologic response modifiers are a diverse group of medications that have emerged over the last decade. They target pro-inflammatory cytokines or cell surface molecules that drive illnesses such as rheumatoid arthritis. Despite the greater control afforded they have also ushered in a new spectrum of side effects. As the same immunologic machinery that helps control infections such as HBV contributes to the pathogenesis of rheumatologic diseases, persistence or reactivation of the virus remains an evolving concern. AREAS COVERED: A systemic literature review was performed using the PubMed and Medline databases (1996 to January 2010) searching for the index term 'Hepatitis B' combined with the terms 'tumor necrosis factor', 'B cell', 'rituximab', 'IL-1', 'anakinra', 'IL-6', 'tocilizumab', 'CTLA-4', and 'abatacept'. All relevant articles in English were reviewed and secondary references of interest were also retrieved. This paper addresses the role of the various cytokines and cluster of differentiation molecules in controlling HBVinfection and the currently known effect that the biologic response modifiers have on viral control by the host immune response. EXPERT OPINION: The risk of HBV reactivation is greatest in HBsAg positive patients. These patients should start antiviral therapy one week before receiving a biologic response modifier. The risk of HBV reactivation in HBsAg negative patients appears very low but when HBsAb titers are low use of rituximab or TNF-alpha antagonists may increase the risk of reactivation.
机译：简介：生物反应调节剂是过去十年中出现的多种药物。它们靶向促发类风湿关节炎等疾病的促炎性细胞因子或细胞表面分子。尽管提供了更大的控制权，他们也迎来了一系列新的副作用。由于有助于控制感染（例如HBV）的相同免疫学机制导致风湿性疾病的发病机理，病毒的持久性或再活化仍然是一个不断发展的问题。覆盖的区域：使用PubMed和Medline数据库（1996年至2010年）进行系统的文献综述，搜索索引词“乙型肝炎”与术语“肿瘤坏死因子”，“ B细胞”，“利妥昔单抗”，“ IL-1”，“ anakinra”，“ IL-6”，“ tocilizumab”，“ CTLA-4”和“ abatacept”。审查了所有英文相关文章，还检索了感兴趣的次要参考文献。本文探讨了各种细胞因子和分化分子簇在控制HBV感染中的作用，以及生物学应答修饰剂对宿主免疫应答对病毒控制的当前已知作用。专家意见：HBsAg阳性患者中HBV重新激活的风险最大。这些患者应在接受生物反应调节剂前一周开始抗病毒治疗。 HBsAg阴性患者中HBV重新激活的风险似乎很低，但是当HBsAb滴度较低时，使用利妥昔单抗或TNF-α拮抗剂可能会增加重新激活的风险。

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