Safety of Infliximab in Inflammatory Bowel Disease Patients With HBV Infection
10.3969/j.issn.1008-7125.2017.10.002
- VernacularTitle:英夫利西单抗在HBV感染炎症性肠病患者中使用的安全性
- Author:
Zhanghan DAI
1
;
Tianrong WANG
;
Qing ZHENG
;
Zhihua RAN
Author Information
1. 上海交通大学医学院附属仁济医院消化内科 200127
- Keywords:
Hepatitis B Virus;
Inflammatory Bowel Disease;
Infliximab;
Immunosuppressive Agents;
Antiviral Therapy;
Safety
- From:
Chinese Journal of Gastroenterology
2017;22(10):582-587
- CountryChina
- Language:Chinese
-
Abstract:
Background:Reactivation of hepatitis B virus (HBV)in the context of immunosuppressive therapy is serious. Biological agents are known having the effect to increase the risk of HBV reactivation in patients with inflammatory bowel disease (IBD)who are seropositive for HBsAg and/ or HBcAb. Aims:To study the HBV reactivation in IBD patients with HBV infection who are treated with infliximab (IFX)in China. Methods:A retrospective study was conducted between March 2014 and March 2017 in Shanghai Renji Hospital. Consecutive IBD patients who were seropositive for HBcAb and treated with IFX were enrolled. The clinical and follow-up data were analyzed and the changes in viral replication and liver function were recorded. Results:Of the 194 IBD patients treated with IFX,28 had active or prior HBV infection. The overall prevalence of HBV infection was 14. 4%,and that of active infection was 4. 6% . The mean number of IFX treatment course was 6. 96 ± 3. 47,and the mean follow-up period was (15. 32 ± 10. 47)months. Fifteen patients (53. 6%)received prophylactic antiviral treatment,one with lamivudine and 14 with entecavir. Ten patients (35. 7%) received synergistic treatment with immunosuppressants,of which,one (10. 0%)with active HVB infection (HBsAg positive and HBV-DNA negative)suffered HBV reactivation. In this reactivation case,lamivudine antiviral prophylaxis was used initially and the reactivation was resolved when entecavir was used instead of lamivudine. Conclusions:IBD patients receiving IFX treatment should be screened for HBV infection. In patients who are seropositive for HBsAg and/ or HBcAb, prophylactic antiviral agents with low resistance rate is recommended for preventing HBV reactivation when IFX and immunosuppressants are synergistically used.
