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Despite recent advances in direct antiviral agents for hepatitis C virus (HCV), this infectious disease remains prevalent worldwide and presents a major therapeutic challenge in patients with rheumatoid arthritis (RA).1 Our previous report demonstrated that use of antitumour necrosis factor (TNF)-α agents in patients with RA with HCV infection appears to be safe.2 However, B-cell-targeted therapy with rituximab may lead to HCV viraemia by causing a decline in exosomal microRNAs.3 Therefore, HCV viral replication may respond differently to biologic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) owing to the different mechanism of action in patients with RA.
Viral loads in HCV-infected patients with RA were reported to be unaffected during short-term therapy with tocilizumab, a monoclonal antibody targeting interleukin (IL)-6 receptor.4 5 Abatacept, a fusion protein binding cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) that blocks the CD80/CD86 costimulatory pathways, has also been shown to be safe in patients with RA with HCV.6 It remains unclear whether tofacitinib, a Janus kinase (JAK) inhibitor,7 affects HCV viral activity in patients with RA. To …
Handling editor Josef S Smolen
Contributors Y-MC and W-NH conceived and designed the study, conducted the data analysis, and drafted and revised the manuscript. J-PC performed the statistical analysis and revised the manuscript. T-LL, S-SY, H-HC, T-YH and W-TH acquired clinical data and revised the manuscript. D-YC and Y-HC generated the original hypothesis, conceived and designed the study, acquired clinical data, conducted the data analysis, and drafted and revised the manuscript.
Funding This study was supported by a grant from Taichung Veterans General Hospital, Taiwan (TCVGH-1077307C).
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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