Digestive Diseases and Sciences

, Volume 58, Issue 4, pp 1149–1156

The Influence of Anti-TNF Therapy on the Course of Chronic Hepatitis C Virus Infection in Patients with Inflammatory Bowel Disease

  • Ming Valerie Lin
  • Wojciech Blonski
  • Anna M. Buchner
  • K. Rajender Reddy
  • Gary R. Lichtenstein
Original Article

Abstract

Background

The immunosuppressive potential of anti-tumor necrosis factor (TNF) in exacerbating chronic hepatitis C virus (HCV) infection has been a major concern. We aim to critically analyze the impact of anti-TNF on the course of chronic HCV infection in patients with concurrent inflammatory bowel disease (IBD) and HCV infection.

Materials and Methods

Patients with diagnosis of IBD and HCV were identified retrospectively through the University of Pennsylvania Health System electronic database. Data assessed included demographics, duration of IBD and HCV infection, HCV RNA levels, HCV genotype, liver histology, hepatic biochemical tests (HBT) and IBD disease activity index.

Results

A total of 4,274 IBD and 3,523 HCV patients were identified from 10/1998 to 05/2010. Thirty-seven patients had concurrent HCV infection and IBD, of which 23 patients were eligible (61 % CD; 39 % UC). Five patients (22 %) received anti-TNF therapy (infliximab). Two patients received pegylated interferon and ribavirin (both were non-responders). Overall, three patients had clinical remission and one patient had clinical response to infliximab. When compared to baseline, one patient had HBT improvement, three patients remained stable and one patient had HBT elevation, which was likely due to progressive liver disease in view of HIV co-infection.

Conclusion

This represents the first critical analysis assessing the impact of anti-TNF therapy on the course of chronic HCV in IBD patients. Concurrent HCV infection in IBD patients is uncommon. Treatment of IBD with infliximab in HCV patients did not result in flares in hepatic biochemical tests while there was an improvement in the IBD disease activity score.

Keywords

Inflammatory bowel disease Ulcerative colitis Crohn’s disease Hepatitis C virus infection Anti-TNF Infliximab 

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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Ming Valerie Lin
    • 1
  • Wojciech Blonski
    • 2
    • 3
  • Anna M. Buchner
    • 2
  • K. Rajender Reddy
    • 2
  • Gary R. Lichtenstein
    • 2
    • 4
  1. 1.Division of Digestive DiseaseUniversity of CincinnatiCincinnatiUSA
  2. 2.Division of GastroenterologyUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of GastroenterologyMedical UniversityWrocławPoland
  4. 4.Gastroenterology DivisionUniversity of Pennsylvania School of Medicine, Hospital of the University of PennsylvaniaPhiladelphiaUSA

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