Predictors of hepatitis B and C virus reactivation in patients with psoriasis treated with biological agent: A nine-year multicenter cohort study.

Abstract:

BACKGROUND:The increasing use of biologics is accompanied by a risk of hepatitis B (HBV) and C virus (HCV) reactivation. OBJECTIVE:To determine the predictors of HBV and HCV reactivation in psoriasis patients receiving biologics. METHODS:This study screened 2060 psoriasis patients (3562 treatment episodes) who were taking biologics from 2009 to 2018. There were 359 psoriasis patients with HBV (561 treatment episodes) and 61 with HCV infection (112 treatment episodes). RESULTS:During 8809 and 1522 person-months of follow-up, 88 treatment episodes for HBV involved HBV reactivation, and 14 episodes of HCV involved reactivation. The reactivation rate was significantly higher in treatment episodes of chronic HBV infection than that of occult HBV (34.3% vs. 3.2%, p=0.001) and resolved HBV (34.3% vs. 5.0%, p < 0.001). The multivariate analysis revealed that being HBsAg-seropositive, being HBeAg-seropositive, and TNF-α inhibitor therapy were risk factors for HBVr, while antiviral prophylaxis was effective in reducing the risk of HBV reactivation. No predictors were significantly associated with HCV reactivation. LIMITATIONS:Observational design and a lack of a comparison group. CONCLUSIONS:Psoriasis patients on biologics have a risk of HBV and HCV reactivations, particularly those who are HBsAg-seropositive, HBeAg-seropositive, and undergoing TNF-α inhibitor therapy.

journal_name

J Am Acad Dermatol

authors

Chiu HY,Chiu YM,Chang Liao NF,Chi CC,Tsai TF,Hsieh CY,Hsieh TY,Lai KL,Chiu TM,Wu NL,Hui RC,Lee CN,Wang TS,Chen PH,Yang CC,Huang YH

doi

10.1016/j.jaad.2019.12.001

subject

Has Abstract

pub_date

2019-12-07 00:00:00

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(19)33209-8

pub_type

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