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It’s not only DAAs than can reactivate HBV. In patients with inflammatory arthritis receiving disease-modifying antirheumatic drugs (DMARDs), rates of hepatitis B (HBV) reactivation differ between those whose disease is resolved and those with chronic HBV infection. Findings from the systematic review and meta-analysis were published in Arthritis Care & Research (Hoboken).
Patients with chronic HBV generally have a 5-fold to 8-fold higher risk for HBV reactivation than those with resolved HBV. Evidence over the past 2 decades has suggested that HBV reactivation is associated with the use of tumor necrosis factor (TNF) biologic DMARDs in patients with such inflammatory disorders as rheumatoid arthritis and psoriatic arthritis. Additional reports have demonstrated HBV reactivation among those treated with such non-TNF DMARDs as abatacept and tocilizumab.