From the medical board of the national psoriasis foundation: Recommendations for screening for hepatitis B infection prior to initiating anti-tumor necrosis factor-alfa inhibitors or other immunosuppressive agents in patients with psoriasis

Kiran Motaparthi, Vladimir Stanisic, Abby S. Van Voorhees, Mark G. Lebwohl, Sylvia Hsu

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

Background No consensus exists regarding the optimal laboratory screening for hepatitis B infection that should be performed before initiating therapy with tumor necrosis factor-alfa inhibitors or other immunosuppressive agents. Objective We sought to give guidelines on which tests to order for hepatitis B screening. Methods We review the pathophysiology and serology of hepatitis B infection and provide recommendations for screening for hepatitis B infection in patients with psoriasis before beginning anti-tumor necrosis factor-alfa therapy or other immunosuppressive agents. Results We propose the standardized use of triple serology testing: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody in combination with liver function tests as screening. Limitations Conclusions based on review of available literature is a limitation. Conclusions All patients with psoriasis who are candidates for tumor necrosis factor-alfa inhibitor should undergo screening for hepatitis B virus infection using the triple serology: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. It is advisable that patients, who are candidates for ustekinumab, cyclosporine, or methotrexate undergo the same screening.

Original languageEnglish
Pages (from-to)178-186
Number of pages9
JournalJournal of the American Academy of Dermatology
Volume70
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • anti-tumor necrosis factor-alfa
  • biologic therapy
  • cyclosporine
  • hepatitis B
  • methotrexate
  • psoriasis
  • ustekinumab

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