PMID- 18221983
OWN - NLM
STAT- MEDLINE
DCOM- 20090203
LR  - 20151119
IS  - 1532-866X (Electronic)
IS  - 0049-0172 (Linking)
VI  - 38
IP  - 3
DP  - 2008 Dec
TI  - Use of tumor necrosis factor-alpha inhibitors in patients with chronic hepatitis 
      B infection.
PG  - 208-17
LID - 10.1016/j.semarthrit.2007.10.011 [doi]
AB  - OBJECTIVE: Tumor necrosis factor-alpha (TNF-alpha) inhibitors have emerged as a 
      potent treatment for rheumatoid arthritis (RA), but not without significant 
      risks. In chronic hepatitis B viral infection TNF-alpha is readily produced, and 
      viral clearance is dependent on the amount bioavailable. Limited data suggest 
      that TNF-alpha inhibitors may facilitate uncontrolled hepatitis B viral 
      replication. The purpose of this article was to provide a detailed review of the 
      role of TNF-alpha in controlling hepatitis B viral infection and the clinical 
      impact blockade might have on viral control. METHODS: We describe a patient with 
      chronic hepatitis B viral infection and RA treated with etanercept. We then 
      review case reports, expert opinion, and manufacturer recommendations regarding 
      hepatitis B viral infection, TNF-alpha, and TNF-alpha inhibitors. RESULTS: To 
      date, 13 patients with chronic hepatitis B infection treated with TNF-alpha 
      inhibitors have been reported: 11 with infliximab and 2 with etanercept. Some 
      patients received antiviral therapy for hepatitis B (specifically lamivudine) 
      before, during, or after TNF-alpha inhibitors were started. Clinically apparent 
      reactivation of hepatitis B virus typically occurred 1 month after the 3rd dose 
      of infliximab. Etanercept was not associated with a similar reactivation. The 
      difference between infliximab and etanercept in viral reactivation may be linked 
      to the pharmacologic difference of each medication. CONCLUSIONS: TNF-alpha 
      inhibitors in general should be used cautiously in chronic hepatitis B viral 
      infection. But if necessary, when deciding which agent to use, the clinician 
      should consider the mechanism by which the body clears TNF-alpha.
FAU - Carroll, Matthew B
AU  - Carroll MB
AD  - San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Wilford 
      Hall Medical Center, Lackland Air Force Base, Lackland, Texas, USA. 
      matthew.carroll@keesler.af.mil
FAU - Bond, Michael I
AU  - Bond MI
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20080125
PL  - United States
TA  - Semin Arthritis Rheum
JT  - Seminars in arthritis and rheumatism
JID - 1306053
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antiviral Agents)
RN  - 0 (DNA, Viral)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 2T8Q726O95 (Lamivudine)
RN  - B72HH48FLU (Infliximab)
RN  - OP401G7OJC (Etanercept)
SB  - IM
MH  - Aged
MH  - Antibodies, Monoclonal/adverse effects/*therapeutic use
MH  - Antiviral Agents/therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy/virology
MH  - DNA, Viral/blood
MH  - Drug Therapy, Combination
MH  - Etanercept
MH  - Hepatitis B virus/drug effects/genetics
MH  - Hepatitis B, Chronic/complications/*drug therapy
MH  - Humans
MH  - Immunoglobulin G/adverse effects/metabolism/*therapeutic use
MH  - Immunosuppressive Agents/adverse effects/metabolism/*therapeutic use
MH  - Infliximab
MH  - Lamivudine/therapeutic use
MH  - Male
MH  - Receptors, Tumor Necrosis Factor/metabolism/*therapeutic use
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
RF  - 58
EDAT- 2008/01/29 09:00
MHDA- 2009/02/04 09:00
CRDT- 2008/01/29 09:00
PHST- 2007/03/28 00:00 [received]
PHST- 2007/06/18 00:00 [revised]
PHST- 2007/10/07 00:00 [accepted]
PHST- 2008/01/29 09:00 [pubmed]
PHST- 2009/02/04 09:00 [medline]
PHST- 2008/01/29 09:00 [entrez]
AID - S0049-0172(07)00179-5 [pii]
AID - 10.1016/j.semarthrit.2007.10.011 [doi]
PST - ppublish
SO  - Semin Arthritis Rheum. 2008 Dec;38(3):208-17. doi: 
      10.1016/j.semarthrit.2007.10.011. Epub 2008 Jan 25.