Published experience of patients with rheumatic disease and underlying HBV infection treated with biological agents
| Patient No | Reference | Diagnosis | Age/sex | Biological immunosuppressive therapy | Baseline serology | Treatment and outcome |
|---|---|---|---|---|---|---|
| AS, ankylosing spondylitis; M, male; IV, intravenously; NR, not reported; LAM, lamivudine; RA, rheumatoid arthritis; MTX, methotrexate; AOSD, adult onset Still’s disease; F, female; SpA, spondyloarthropathy; SC, subcutaneously. | ||||||
| 1 | 6 | AS | 32/M | Infliximab 5 mg/kg IV × 3 (0, 2, 6 weeks) | HBsAg+ HBeAg:NR | Pre-emptive LAM before infliximab × 1 year, well tolerated |
| 2 | 7 | RA | 49/M | Infliximab 6mg/kg IV every 2 months, MTX 10 mg/week × 18 months, prednisone 8 mg/day | HBsAg+ HBeAg− Anti-HBe+ | Flare of HBV, infliximab and MTX stopped, treated successfully with LAM |
| 3 | 5 | AOSD | 28/F | Infliximab 5 mg/kg IV × 2 (0, 2 weeks) | HBsAg+ HBeAg−Anti-HBe+ | Acute hepatitis with severe liver decompensation without evidence of HBV reactivation in serum or liver, successful liver transplantation |
| 4 | 35 | SpA | 35/F | Infliximab 5 mg/kg IV ×3 (0, 2, 6 weeks) and then every 8 weeks for 4 months | HBsAg+HBeAg− | HBV reactivation, successful treatment with LAM, restarted infliximab without incident |
| 5 | 4 | RA | 58/F | Infliximab 3 mg/kg IV every 8 weeks then etanercept 25 mg SC twice weekly | HBsAg+HBeAg−Anti-HBe+ | Previously flared while receiving MTX treatment; treated pre-emptively with LAM; infliximab and etanercept well tolerated |