Infliximab therapy for rheumatic diseases in patients with chronic hepatitis B or C

Objective. To describe the safety of tumor necrosis factor-alpha blockade in 2 patients with inflammatory rheumatic disease with chronic hepatitis B and C. Methods. We used infliximab therapy in 2 patients with chronic inflammatory joint disease and chronic hepatitis B or C. We describe the clinical and laboratory test data obtained in these patients during the first year of treatment. Disease activity, liver function tests, and HCV and HBV status were evaluated before infliximab therapy was started and were reevaluated before each infusion. Liver biopsy was performed in both patients before infliximab therapy. Result. After more than one year of treatment, no worsening in liver function or virological status was observed, while a dramatic clinical improvement of joint disease was observed in both patients. Conclusion. These cases suggest that infliximab therapy may be safe in some quiescent or controlled chronic HBV or HCV infection. (J Rheumatol 2004;31:107-9).