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Hepatitis C virus (HCV) infection is prevalent worldwide and is associated with cirrhosis and hepatocellular carcinoma. Although antitumour necrosis factor (anti-TNF) α agents may affect the competence of the immune system against viral infection,1 some studies have demonstrated that TNF-α inhibitors may be safe in patients with chronic HCV infection.2 ,3 A recent randomised clinical trial showed that rheumatoid arthritis (RA) patients with chronic HCV were treated successfully with etanercept without elevation of transaminases and HCV viral load.4 However, rituximab (RTX) is associated with increasing HCV RNA levels in lymphoma patients undergoing RTX combined with chemotherapy.5 ,6 RTX-related HCV reactivation was also observed in RA patients.7 Therefore, biological therapies of different mechanism of action may influence on HCV replication differently. To test this hypothesis, we conducted a retrospective safety profile review of RA patients with concomitant HCV infection treated …
Contributors All authors made substantial intellectual contributions to the conception of the work, analysis and interpretation of the data, and drafting and revising the manuscript.
Competing interests None.
Patient consent Obtained.
Ethics approval The Ethics Committee of Taichung Veterans General Hospital.
Provenance and peer review Not commissioned; externally peer reviewed.