Reuters Health Information (2004-09-06): Infliximab for Crohn's disease may activate chronic hepatitis B
Infliximab for Crohn's disease may activate chronic hepatitis B
Last Updated: 2004-09-06 7:30:25 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Infliximab therapy for
Crohn's disease may be associated with reactivation of chronic
hepatitis B (HBV) infection, Spanish researchers report in the
September issue of Gut.
In fact, lead investigator Dr. Maria Esteve from Hospital
Universitari M�tua de Terrassa, Barcelona, told Reuters Health, "when
possible, all patients with Crohn's disease should be vaccinated to
avoid reactivation related to immunosuppression," particularly when
being treated with infliximab.
Dr. Esteve and colleagues prospectively monitored hepatitis B and C
markers and liver function test results in 80 Crohn's disease patients
requiring infliximab infusion.
Three had chronic HBV infection at the time of the infusion. Two of
these patients, a 34-year-old man and a 38-year-old man, experienced
severe reactivation of chronic HBV months later. The 38-year-old
patient died of HBV complications while awaiting liver transplantation.
No other patients showed significant changes in hepatic function.
Only one patient had positive anti-hepatitis C virus (HCV) antibodies,
the researchers note, but was HCV RNA negative and aminotransferase
levels remained normal.
Given these findings, Dr. Esteve said that "careful monitoring of
viral hepatitis infection is advised in Crohn's disease patients
Moreover, "antiviral therapy--with lamivudine or adefovir
dipivoxil--should be administered to those patients requiring
infliximab therapy who exhibit positive surface antigen-HbsAg--with or
without active viral replication."