Roux C H, Brocq O, Breuil V, Albert C, Euller-Ziegler L
Hospital l'Archet 1, Rheumatology Department, 242 Avenue de Saint Antoine de Ginestiere, 06200 Nice, France.
Rheumatology (Oxford). 2006 Oct;45(10):1294-7. doi: 10.1093/rheumatology/kel123. Epub 2006 Apr 7.
To assess the safety of anti-tumour necrosis factor (TNF)-alpha therapy in patients with rheumatoid arthritis (RA) or spondylarthropathies (SA) and concurrent chronic hepatitis B or C.
Records concerning 480 outpatients attending the Rheumatology Department of the University Hospital of Nice (France) for RA or SA were retrospectively reviewed for the duration of disease, treatment, serological status and biological data.
Six relevant cases were identified: two of RA with chronic hepatitis B; one of SA with chronic hepatitis B and three of RA with chronic hepatitis C. Five patients had received etanercept and one infliximab; two had been given adalimumab after an unsuccessful trial of etanercept. Patients with concurrent chronic hepatitis B were also given lamivudine. In none of the cases had changes in serum aminotransferases or viral load been reported.
The use of anti-TNF-alpha therapy (plus lamivudine in the presence of concurrent underlying hepatitis B viral infection) appeared to be safe in that it had no effect on serum aminotransferases and/or viral load. However, repeated monitoring is necessary throughout the treatment period.
评估抗肿瘤坏死因子（TNF）-α治疗对类风湿关节炎（RA）或脊柱关节病（SA）合并慢性乙型或丙型肝炎患者的安全性。
回顾性分析法国尼斯大学医院风湿科480例因RA或SA就诊的门诊患者的疾病病程、治疗情况、血清学状态及生物学数据。
确定了6例相关病例：2例RA合并慢性乙型肝炎；1例SA合并慢性乙型肝炎，3例RA合并慢性丙型肝炎。5例患者接受了依那西普治疗，1例接受了英夫利昔单抗治疗；2例在依那西普治疗失败后使用了阿达木单抗。合并慢性乙型肝炎的患者还接受了拉米夫定治疗。所有病例均未报告血清转氨酶或病毒载量的变化。
使用抗肿瘤坏死因子-α治疗（合并潜在乙型肝炎病毒感染时加用拉米夫定）似乎是安全的，因为它对血清转氨酶和/或病毒载量没有影响。然而，在整个治疗期间需要进行反复监测。
