Etanercept: safetyinpatientswith HCV- andHBV-infectionandlatent tuberculosis, risk of bacterial infections and vaccinations (part 2

Etanercept is safe in patients with HCV-infection and may be used in combination with interferon and ribavirin. However, strict monitoring of liver enzymes is recommended during treatment with tumour necrosis factor (TNF) inhibitor. Like all biologic agents, etanercept can induce reactivation of HBVinfection. Antiviral agents, e.g. entecavir and tenofovir, should be used to prevent progression of hepatitis B. All TNF inhibitors can cause reactivation of latent tuberculosis. This risk is lower during treatment with etanercept. Screening for latent tuberculosis should include tuberculin test and chest Xray and is recommended prior to treatment with any TNF inhibitor. A risk of serious bacterial infections during etanercept treatment is probably lower than during treatment with other TNF inhibitors. Unlike rituximab, TNF inhibitor do not impair efficacy of vaccination agaings influenza and pneumococcal infections.

Key words

Etanercept, HСV, HBV, latent tuberculosis, bacterial infections, vaccination.