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How do you manage patients who are Hepatitis B core antibody positive/surface antigen negative and starting a biologic DMARD (other than rituximab)?

1 Answer
Mednet MemberInvited Expert
Rheumatology · Harvard Medical School
Answered on

According to the 2015 American College of Rheumatology Guidelines, a patient with natural immunity to Hepatitis B (Core & Surface Antibody-positive; Antigen-negative, normal liver function tests) can be treated as any other patient. However, monitoring of viral load is recommended "regularly" at 6-12 month intervals. New guidelines will soon be released but it seems unlikely to me that this recommendation will change. When in doubt, co-management with an infectious disease specialist or hepatologist can be helpful.

Singh, Jasvinder A., et al. "2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis." Arthritis & Rheumatology 68.1 (2016): 1-26.