Patients with rheumatoid arthritis and resolved hepatitis B virus infection who underwent treatment with rituximab did not experience reactivation of the infection, according to results of a multicenter Italian study.
Researchers retrospectively studied data from 306 consecutive patients with rheumatoid arthritis (RA) who received treatment with rituximab (Rituxan, Genentech/Biogen Idec). Complete serological screening for prior infection with hepatitis B virus (HBV) was available for 216 patients and included tests for negativity to the hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antigen (anti-HBc), anti-hepatitis B envelope antigen (anti-HBe) and serum HBV DNA prior to treatment with rituximab. Thirty-nine patients (18%) were negative for HBsAg and positive for anti-HBc, six of whom received prior treatment with lamivudine and were excluded. Twenty-eight patients had protective anti-HBs titers and two had chronic hepatitis C virus infections at baseline.
Patients received at least three injections of 1,000-mg rituximab on day 1 and day 15 every 6 months and were followed with clinical and laboratory examinations, including measurements of serum HBsAg and HBV DNA.