Reactivation of Hepatitis B after Administration of Anti-TNF<i>α</i> in a Patient with Psoriasis

Abstract

In patients with severe psoriasis that at the same time have multiple comorbidities and chronic infections, is difficult to establish safer and more effective therapy. There are contradictions between the indications of the international protocols of systemic treatments, and the most recent publications which show that anti-TNF<i>α</i> agents could be safe therapeutic options in patients with chronic hepatitis. In the case of chronic viral infections, specifically hepatitis B, there are several conflicts in reference to the biological treatments that can block tumoral necrosis factor-<i>α</i> (TNF<i>α</i>) because there is evidence of a risk of reactivation of hepatitis. Most viral reactivations with the administration of an anti-TNF<i>α</i> agent have been reported in patients with inflammatory diseases. However, there are a few cases described in psoriasis. We’ll present the first case reported in literature of hepatisis B viral (HBV) reactivation in a patient with severe psoriasis secondary to the administration of adalimumab

Safety of therapies using ustekinumab in patients with psoriasis who have had hepatitis B virus infection

“…32 There are also reports evaluating the risk of HBV-r in psoriatic patients that undergone TNF-i treatment with underlying chronic, occult, or past HBV infection. [33][34][35][36][37][38][39][40][41] Patients at highest risk of HBV-r are those with chronic HBV infection À20% to 50%. Lower risk patients are those with past HBV.…”