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Rheumatic manifestations of hepatitis

Vassilopoulos, Dimitrios; Manolakopoulos, Spilios

Current Opinion in Rheumatology: January 2010 - Volume 22 - Issue 1 - p 91–96
doi: 10.1097/BOR.0b013e328333ba5d
Systemic disorders with rheumatic manifestations: Edited by Jonathan Kay
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Purpose of the review Rheumatic manifestations are commonly encountered in patients with hepatitis B virus (HBV) or C (HCV) infection. In this review the most common clinical rheumatic manifestations of HBV or HCV infection and their management will be critically presented with a special emphasis on the efficacy and safety of the new biologic agents.

Recent findings Recent significant advances in the antiviral therapy of chronic hepatitis B and C as well as the emergence of new biologic therapies (anti-TNF agents, rituximab) for the treatment of rheumatic diseases have changed significantly the therapeutic approach for patients with rheumatic disorders in the setting of hepatitis B or C. For patients with hepatitis B, prophylactic antiviral therapy with oral antiviral agents (nucleoside or nucleotide analogues) is recommended for all cases in which immunosuppressive therapies are administered, whereas for severe hepatitis C-associated mixed cryoglobulinemia, a number of recent studies have shown the short-term safety and efficacy of rituximab.

Summary Rheumatologists in collaboration with hepatologists have today an array of efficacious therapeutic options to explore for patients presenting with rheumatic disorders in the setting of a co-existent HBV or HCV infection. Appropriate pretreatment screening and close monitoring are essential for these difficult-to-treat patients.

2nd Department of Medicine, Athens University School of Medicine, Hippokration General Hospital, Athens, Greece

Correspondence to Dimitrios Vassilopoulos, MD, Assistant Professor of Medicine-Rheumatology, 2nd Department of Medicine, Athens University School of Medicine, Hippokration General Hospital, 114 Vass. Sophias Ave., 115 27 Athens, Greece Tel: +210 7774742; fax: +210 7481771; e-mail: dvassilop@med.uoa.gr

© 2010 Lippincott Williams & Wilkins, Inc.