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pubmed-article:20306568pubmed:abstractTextWe report a case of reactivation of hepatitis B virus (HBV) infection with subacute liver failure during administration of adalimumab, followed by a literature review of all 19 published cases, with a focus on the effect of antiviral prophylaxis. Eight patients were given prophylaxis and had a good outcome. Of the 11 patients without prophylaxis, six patients developed a reactivation and needed to stop anti-TNFalpha therapy (P = 0.017). One patient developed an acute liver failure, necessitating urgent liver transplantation. One patient died. Administration of anti-TNFalpha therapy can lead to HBV reactivation, with a possible lethal outcome. High-risk patients and possibly all patients should be screened for hepatitis B surface antigen and anti-HBV core antibody before starting anti-TNFalpha therapy. Administration of antiviral prophylaxis proves beneficial in prevention of reactivation in hepatitis B surface antigen positive patients.lld:pubmed
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pubmed-article:20306568pubmed:articleTitleSubfulminant hepatitis B during treatment with adalimumab in a patient with rheumatoid arthritis and chronic hepatitis B.lld:pubmed
pubmed-article:20306568pubmed:affiliationDepartment of Gastroenterology and Hepatology, Ghent University Hospital, De Pintelaan 185, Ghent B-9000, Belgium. xavierverhelst@gmail.comlld:pubmed
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