Background With the use of biological therapy, cases of reactivation of hepatitis B (HBV) and C (HCV) have been described, consequently its use has to be carefully evaluated. In some cases these therapies have to be administered together with antiviral treatment. Despite the fact that before the beginning of the biological therapy the screening of HBV and HCV virus is done, during the course of treatment serologies are no longer used to detect serovonversions.
Objectives To analyze the prevalence of HBV and HCV in patients with rheumatic disease at the beginning of biological therapies. To identify the cases of hepatitis reactivation.
Methods Retrospective observational analysis of the biological treatments administered to patients with rheumatic Disease of the rheumatology department of La Fe hospital, during the period 2000–2015 who had HBV and/or HCV serology at the beginning of treatment. Demographic data and diagnosis of the patient, months of treatment and the results of the serologies performed at the beginning and in the follow-up of the treatment, and the cases of reactivation of hepatitis have been collected.
Results A total of 388 patients were selected of which 62.4% were female; the mean age at diagnosis of was 38.96±14.36 years. 49.5% of the patients were diagnosed with rheumatoid arthritis (RA), 25.3% of ankylosing spondylitis (AE), 18.6% of psoriatic arthritis (APSO) and 6.7% with other diagnoses. The mean treatment time with patients' biological therapy is 200±118 months (3–464 months), and the mean time between the two serologies is 172±102 months (18–460 months). An incidence of 10% of cases with HBV infection (39 patients) is observed. The serological pattern was 8 cases with Ac-core (+) HBV/Ac-surface (-)/Ag-surface (-) HBV and 31 HBV/Ac- surface (-). The incidence of HCV at the start of treatment was 1.1% (4 patients). A case of reactivation (12.5%) was detected among the 8 patients with Ac-core (+)/Ac-surface (-)/Ag-surface (-) HBV. The patient had infliximab and methotrexate, and reactivation was observed after 12 years of treatment. No reactivation of HCV has been detected.
Conclusions In our series of patients the incidence of HBV and HCV has been 10% and 1.1%, respectively. One of the 8 patients with Ac-core (+)/Ac-surface (-)/Ag-surface (-) HBV, had reactivation of the virus.
Disclosure of Interest None declared