Risk of hepatitis B virus reactivation in rheumatoid arthritis patients undergoing biologic treatment: Extending perspective from old to newer drugs  

作　　者：Francesca De Nard Monica Todoerti Vittorio Grosso Sara Monti Silvia Breda Silvia Rossi Carlomaurizio Montecucco Roberto Caporali 

机构地区：[1]IRCCS Policlinico San Matteo Foundation, Chair and Division of Rheumatology, University of Pavia

出　　处：《World Journal of Hepatology》2015年第3期344-361,共18页世界肝病学杂志（英文版）（电子版）

摘　　要：Hepatitis B virus(HBV) reactivation in rheumatoid arthritis(RA) patients undergoing biological therapy is not infrequent. This condition can occur in patients with chronic hepatitis B as well as in patients with resolved HBV infection. Current recommendations are mainlyfocused on prevention and management strategies of viral reactivation under tumor necrosis factor-α inhibitors or chimeric monoclonal antibody rituximab. In recent years, growing data concerning HBV reactivation in RA patients treated with newer biological drugs like tocilizumab and abatacept have cumulated. In this review, epidemiology, pathogenesis and natural history of HBV infection have been revised first, mainly focusing on the role that specific therapeutic targets of current biotechnological drugs play in HBV pathobiology; finally we have summarized current evidences from scientific literature, including either observational studies and case reports as well, concerning HBV reactivation under different classes of biological drugs in RA patients. Taking all these evidences into account, some practical guidelines for screening, vaccination, prophylaxis and treatment of HBV reactivation have been proposed.Hepatitis B virus （HBV） reactivation in rheumatoidarthritis （RA） patients undergoing biological therapy isnot infrequent. This condition can occur in patients withchronic hepatitis B as well as in patients with resolvedHBV infection. Current recommendations are mainlyfocused on prevention and management strategiesof viral reactivation under tumor necrosis factor-αinhibitors or chimeric monoclonal antibody rituximab. Inrecent years, growing data concerning HBV reactivationin RA patients treated with newer biological drugs liketocilizumab and abatacept have cumulated. In thisreview, epidemiology, pathogenesis and natural historyof HBV infection have been revised first, mainly focusingon the role that specific therapeutic targets of currentbiotechnological drugs play in HBV pathobiology; finallywe have summarized current evidences from scientificliterature, including either observational studies andcase reports as well, concerning HBV reactivation underdifferent classes of biological drugs in RA patients.Taking all these evidences into account, some practicalguidelines for screening, vaccination, prophylaxis andtreatment of HBV reactivation have been proposed.

关 键 词：Rheumatoid arthritis Hepatitis B virus BIOLOGICS ANTI-TNF RITUXIMAB TOCILIZUMAB ABATACEPT 

分 类 号：R593.22[医药卫生—内科学]