The use of ustekinumab in a patient with severe psoriasis and positive HBV serology

Abstract

Psoriasis is a chronic inflammatory, immune-mediated disease that affects 1% to 2% of the world's population. Immunobiological medications are prescribed for certain patients with severe forms of psoriasis, however, these drugs increase the risk of reactivation of viral diseases such as hepatitis B. We report the case of a patient with severe psoriasis with positive serology for the Hepatitis B virus, who received ustekinumab (a human monoclonal antibody against interleukin 12 and 23). In this patient, the use of ustekinumab did not reactivate the Hepatitis B virus. Given the high prevalence of chronic viral infections in patients who are candidates for biologic therapy, as well as the potential for reactivate chronic viral illness, randomized controlled studies are needed to assess the risks and benefits of such therapy in these populations.

Sirolimus treatment for cirrhosis or hepatocellular carcinoma patients accompanied by psoriasis after liver transplantation: A single center experience

“…So, when these patients were treated in our center, they all had a lengthy PS history and had been treated in hospital, our diagnosis was based on the earlier diagnosis and treatment of patients by a specialist. Meanwhile, combined with the patient's history including the PASI score, we confirmed the diagnosis and excluded other nonspecific infections with the laboratory (hematological examination, cultivation of the dander ( 11 , 23 , 24 , 26 , 27 ) and imaging (CT and MRI scanning) diagnosis methodology.…”

“…Nevertheless, there is little research on HBV involvement in PS pathogenesis. Previous literature indicates that HBV infection may induce or aggravate PS progress ( 23 – 25 ) and HBV can be detected in PS skin lesions ( 24 , 25 ). The patients included in this study were all diagnosed preoperatively as HBV-positive with lengthy chronic hepatitis B histories.…”

“…As the confirmation of a PS diagnosis is usually based on clinical features, including skin rashes, predilection sites and seasonal onset, most diagnosis is not difficult. The cultivation of the dander which performed by the methods of real-time quantitative PCR and immunohistochemistry usually used to detect the expression of HBV-DNA or other viruses ( 16 , 23 – 25 ) and the expression trends of IL-17/23 ( 7 , 11 ) or TNF-α and INF-γ ( 6 – 8 ). So, when these patients were treated in our center, they all had a lengthy PS history and had been treated in hospital, our diagnosis was based on the earlier diagnosis and treatment of patients by a specialist.…”

Ustekinumab therapy changes the transcriptional activity pattern of TGF-β1–3 genes

“…The patient was severely affected by psoriasis because his BSA score was 81% and the DLQI value was very high. Despite the positive HBV serology, Steglich et al [24] decided to use ustekinumab, supporting the patient's immunity with antiviral drugs. Ustekinumab therapy not only failed to reactivate HBV, but also caused a sudden decrease in BSA to 47% after just 3 weeks of treatment [24].…”

Μελέτη Της HBV Λοίμωξης Και Αναζωπύρωσης Σε Ασθενείς Με Ρευματικές Παθήσεις Υπό Ανοσοκατασταλτική Αγωγή

“…Σε ένα σημαντικό ποσοστό των ασθενών με παρελθούσα λοίμωξη (HBsAg-αρνητικό/anti-HBc-θετικό) μπορούν να ανιχνευθούν κυκλοφορούντα αντισώματα έναντι του αντιγόνου επιφανείας (anti-HBs) 170,171 13,118 , RTX 142 , ABA 148,149 , TCZ [155][156][157] και UST 183,184 . Σε μια προοπτική μελέτη με μακρό χρόνο παρακολούθησης 13…”