Table 3

 Published experience of patients with rheumatic disease and underlying HBV infection treated with biological agents

Patient NoReferenceDiagnosisAge/sexBiological immunosuppressive therapyBaseline serologyTreatment 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.
16AS32/MInfliximab 5 mg/kg IV × 3 (0, 2, 6 weeks)HBsAg+ HBeAg:NRPre-emptive LAM before infliximab × 1 year, well tolerated
27RA49/MInfliximab 6mg/kg IV every 2 months, MTX 10 mg/week × 18 months, prednisone 8 mg/dayHBsAg+ HBeAg− Anti-HBe+Flare of HBV, infliximab and MTX stopped, treated successfully with LAM
35AOSD28/FInfliximab 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
435SpA35/FInfliximab 5 mg/kg IV ×3 (0, 2, 6 weeks) and then every 8 weeks for 4 monthsHBsAg+HBeAg−HBV reactivation, successful treatment with LAM, restarted infliximab without incident
54RA58/FInfliximab 3 mg/kg IV every 8 weeks then etanercept 25 mg SC twice weeklyHBsAg+HBeAg−Anti-HBe+Previously flared while receiving MTX treatment; treated pre-emptively with LAM; infliximab and etanercept well tolerated