- 作者：Kiran Motaparthi ; Vladimir Stanisic ; Abby S. Van Voorhees ; Mark G. Lebwohl ; Sylvia Hsu
- 关键词：anti&ndash ; tumor necrosis factor-alfa ; biologic therapy ; cyclosporine ; hepatitis B ; methotrexate ; psoriasis ; ustekinumab
- 刊名：Journal of the American Academy of Dermatology
- 出版年：January, 2014
- 年：2014
- 卷：70
- 期：1
- 页码：178-186
- 全文大小：787 K
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.