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Successful clearance of hepatitis C virus with pegylated interferon α-2a and ribavirin in an etanercept-treated patient with psoriatic arthritis, hepatitis B virus coinfection and latent tuberculosis
  1. Ingmar Mederacke1,
  2. Torsten Witte2,
  3. Heiner Wedemeyer1,
  4. Dirk Meyer-Olson2
  1. 1Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover, Germany
  2. 2Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover, Germany
  1. Correspondence to Priv.-Doz. Dr Dirk Meyer-Olson, Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany; meyer.dirk{at}mh-hannover.de

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Treatment of viral hepatitis with interferon-based therapies carries the risk of exacerbating underlying autoimmune disorders.1 Tumour necrosis factor alpha (TNFα) inhibitors are widely used in patients with rheumatic diseases, but anti-TNFα treatment may be associated with the reactivation of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection.2 3 Current treatment guidelines on rheumatological diseases,4 chronic HBV5 or HCV6 do not address the possibility of the concomitant administration of interferon and TNFα inhibitors in patients with both rheumatic disease and viral hepatitis.

A 37-year-old man presented to our clinic with a history of HLA-B27-positive psoriatic arthritis and chronic HBV–HCV (genotype 3a) co-infection, with HCV dominance (HCV-RNA 1.88×106 IU/ml, HBV-DNA <12 IU/ml; Roche COBAS TaqMan; Roche, Germany) and hepatitis B e antigen negativity.7 Liver biopsy …

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