Open AccessProgression of viraemia during treatment with infliximab in a patient with rheumatoid arthritis and chronic hepatitis C infection
Author(s) -
Hiroshi Uda,
Makihiko Kuhara,
Norihiro Nishimoto,
Osamu Saiki
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.04.2009.1732
Subject(s) - infliximab , medicine , rheumatoid arthritis , elevated transaminases , gastroenterology , hepatitis c virus , arthritis , hepatitis c , immunology , tumor necrosis factor alpha , virus
Tumour necrosis factor α (TNFα) antagonists are effective for the treatment of rheumatoid arthritis (RA), but concerns remain about their safety in the presence of hepatitis C virus (HCV) infection. The influence of treatment with the TNFα antagonist infliximab on levels of HCV viraemia and serum transaminases in a 38-year-old patient with RA and HCV was examined to assess the safety of the drug. After starting infliximab treatment, the patient's clinical symptoms improved significantly (28-joint Disease Activity Score (DAS28) of less than 3) and levels of transaminases were normal. At the 14th injection of infliximab, the levels of HCV viraemia and transaminases were significantly elevated. After stopping the infliximab injections, the levels of transaminases returned to normal with infusion of glycyrrhizinate derivatives within 3 months. Evidence is provided of aggravation of serum transaminases and progression of viraemia during treatment with infliximab in a patient with RA and HCV infection.