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Chronic hepatitis B reactivation following infliximab therapy in Crohn's disease patients: need for primary prophylaxis.

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dc.creator Esteve i Comas, Maria
dc.creator Saro, C.
dc.creator González-Huix Lladó, Ferran
dc.creator Suárez, F.
dc.creator Forné Bardera, Montserrat
dc.creator Viver i Pi-Suñer, Josep M.
dc.date 2011-07-07T12:31:06Z
dc.date 2011-07-07T12:31:06Z
dc.date 2004
dc.date.accessioned 2024-12-16T10:27:17Z
dc.date.available 2024-12-16T10:27:17Z
dc.identifier 0017-5749
dc.identifier http://hdl.handle.net/2445/18682
dc.identifier 518955
dc.identifier 15306601
dc.identifier.uri http://fima-docencia.ub.edu:8080/xmlui/handle/123456789/22187
dc.description Background: There is little information about the effect of infliximab on the clinical course of liver disease in Crohn's disease patients with concomitant hepatitis B virus (HBV) infection. Theoretically, immunosuppression induced by infliximab will facilitate viral replication which could be followed by a flare or exacerbation of disease when therapy is discontinued. There are no specific recommendations on surveillance and treatment of HBV before infliximab infusion. Two cases of severe hepatic failure related to infliximab infusions have been described in patients with rheumatic diseases. Patients and methods: Hepatitis markers (C and B) and liver function tests were prospectively determined to 80 Crohn's disease patients requiring infliximab infusion in three hospitals in Spain. Results: Three Crohn¿s disease patients with chronic HBV infection were identified. Two of the three patients with chronic HBV infection suffered severe reactivation of chronic hepatitis B after withdrawal of infliximab therapy and one died. A third patient, who was treated with lamivudine at the time of infliximab therapy, had no clinical or biochemical worsening of liver disease during or after therapy. From the remaining 80 patients, six received the hepatitis B vaccine. Three patients had antibodies to both hepatitis B surface antigen (anti-HBs) and hepatitis B core protein (anti-HBc) with normal aminotransferase levels, and one patient had positive anti-hepatitis C virus (HCV) antibodies, negative HCV RNA, and normal aminotransferase levels. Except for the patients with chronic HBV infection, no significant changes in hepatic function were detected. Conclusions: Patients with Crohn's disease who are candidates for infliximab therapy should be tested for hepatitis B serological markers before treatment and considered for prophylaxis of reactivation using antiviral therapy if positive.
dc.format 3 p.
dc.format application/pdf
dc.language eng
dc.publisher BMJ Group
dc.relation Reproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.2004.040675
dc.relation Gut, 2004, vol. 53, núm. 9, p. 1363-1365
dc.relation http://dx.doi.org/10.1136/gut.2004.040675
dc.rights (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 2004
dc.rights info:eu-repo/semantics/openAccess
dc.source Articles publicats en revistes (Medicina)
dc.subject Malaltia de Crohn
dc.subject Hepatitis B
dc.subject Anticossos monoclonals
dc.subject Crohn's disease
dc.subject Hepatitis B
dc.subject Monoclonal antibodies
dc.title Chronic hepatitis B reactivation following infliximab therapy in Crohn's disease patients: need for primary prophylaxis.
dc.type info:eu-repo/semantics/article
dc.type info:eu-repo/semantics/publishedVersion


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