Incidence of HBV Reactivation in Psoriasis Patients Undergoing Cytokine Inhibitor Therapy: A Single-Center Study and Systematic Review with a Meta-Analysis
Background: Psoriasis patients who are seropositive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) face an elevated risk of hepatitis B virus reactivation (HBVr) when treated with cytokine inhibitors. This study aims to elucidate the risk in this population. Methods: A...
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2024-12-01
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| author | Meng Hsuan Kuo Ping-Hung Ko Sz-Tsan Wang Chih-Wei Tseng |
| author_facet | Meng Hsuan Kuo Ping-Hung Ko Sz-Tsan Wang Chih-Wei Tseng |
| author_sort | Meng Hsuan Kuo |
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| description | Background: Psoriasis patients who are seropositive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) face an elevated risk of hepatitis B virus reactivation (HBVr) when treated with cytokine inhibitors. This study aims to elucidate the risk in this population. Methods: A retrospective chart review was conducted to assess the risk of HBVr in 73 psoriasis patients treated with cytokine inhibitors from 2013 to 2023. Additionally, a systematic review and meta-analysis were performed, pooling data from 10 studies (including our cohort) and adhering to PRISMA guidelines. Statistical heterogeneity was assessed using the <i>I</i><sup>2</sup> statistic, and pooled proportions were calculated using a random effects model. Results: No HBVr cases were observed among the 11 HBsAg+ patients in the cohort. However, two of the sixty-two (3.2%) HBsAg−/HBcAb+ patients experienced reactivation during therapy, with outcomes ranging from spontaneous recovery in one case to death from hepatic failure despite antiviral treatment in the other. The meta-analysis, pooling data from 10 studies, revealed a reactivation rate of 21.2% (95% CI: 9.4–41.0%) in HBsAg+ patients without prophylaxis and 4.4% (95% CI: 2.2–8.7%) in HBsAg−/HBcAb+ patients. Conclusion: Antiviral prophylaxis is essential for HBsAg+ patients receiving cytokine inhibitors, given the high risk of reactivation. Despite the lower risk for HBsAg−/HBcAb+ patients, the potential severity of outcomes demands careful monitoring and timely action. |
| format | Article |
| id | doaj-art-540012f84d934752aa4af1116606b48f |
| institution | Kabale University |
| issn | 1999-4915 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj-art-540012f84d934752aa4af1116606b48f2025-01-24T13:52:21ZengMDPI AGViruses1999-49152024-12-011714210.3390/v17010042Incidence of HBV Reactivation in Psoriasis Patients Undergoing Cytokine Inhibitor Therapy: A Single-Center Study and Systematic Review with a Meta-AnalysisMeng Hsuan Kuo0Ping-Hung Ko1Sz-Tsan Wang2Chih-Wei Tseng3Department of Pharmacy, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 622, TaiwanSchool of Medicine, Tzuchi University, Hualien 970, TaiwanSchool of Medicine, Tzuchi University, Hualien 970, TaiwanSchool of Medicine, Tzuchi University, Hualien 970, TaiwanBackground: Psoriasis patients who are seropositive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) face an elevated risk of hepatitis B virus reactivation (HBVr) when treated with cytokine inhibitors. This study aims to elucidate the risk in this population. Methods: A retrospective chart review was conducted to assess the risk of HBVr in 73 psoriasis patients treated with cytokine inhibitors from 2013 to 2023. Additionally, a systematic review and meta-analysis were performed, pooling data from 10 studies (including our cohort) and adhering to PRISMA guidelines. Statistical heterogeneity was assessed using the <i>I</i><sup>2</sup> statistic, and pooled proportions were calculated using a random effects model. Results: No HBVr cases were observed among the 11 HBsAg+ patients in the cohort. However, two of the sixty-two (3.2%) HBsAg−/HBcAb+ patients experienced reactivation during therapy, with outcomes ranging from spontaneous recovery in one case to death from hepatic failure despite antiviral treatment in the other. The meta-analysis, pooling data from 10 studies, revealed a reactivation rate of 21.2% (95% CI: 9.4–41.0%) in HBsAg+ patients without prophylaxis and 4.4% (95% CI: 2.2–8.7%) in HBsAg−/HBcAb+ patients. Conclusion: Antiviral prophylaxis is essential for HBsAg+ patients receiving cytokine inhibitors, given the high risk of reactivation. Despite the lower risk for HBsAg−/HBcAb+ patients, the potential severity of outcomes demands careful monitoring and timely action.https://www.mdpi.com/1999-4915/17/1/42cytokine inhibitorsHBV reactivationinterleukin-17interleukin-23psoriasis |
| spellingShingle | Meng Hsuan Kuo Ping-Hung Ko Sz-Tsan Wang Chih-Wei Tseng Incidence of HBV Reactivation in Psoriasis Patients Undergoing Cytokine Inhibitor Therapy: A Single-Center Study and Systematic Review with a Meta-Analysis Viruses cytokine inhibitors HBV reactivation interleukin-17 interleukin-23 psoriasis |
| title | Incidence of HBV Reactivation in Psoriasis Patients Undergoing Cytokine Inhibitor Therapy: A Single-Center Study and Systematic Review with a Meta-Analysis |
| title_full | Incidence of HBV Reactivation in Psoriasis Patients Undergoing Cytokine Inhibitor Therapy: A Single-Center Study and Systematic Review with a Meta-Analysis |
| title_fullStr | Incidence of HBV Reactivation in Psoriasis Patients Undergoing Cytokine Inhibitor Therapy: A Single-Center Study and Systematic Review with a Meta-Analysis |
| title_full_unstemmed | Incidence of HBV Reactivation in Psoriasis Patients Undergoing Cytokine Inhibitor Therapy: A Single-Center Study and Systematic Review with a Meta-Analysis |
| title_short | Incidence of HBV Reactivation in Psoriasis Patients Undergoing Cytokine Inhibitor Therapy: A Single-Center Study and Systematic Review with a Meta-Analysis |
| title_sort | incidence of hbv reactivation in psoriasis patients undergoing cytokine inhibitor therapy a single center study and systematic review with a meta analysis |
| topic | cytokine inhibitors HBV reactivation interleukin-17 interleukin-23 psoriasis |
| url | https://www.mdpi.com/1999-4915/17/1/42 |
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