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Infections are a major adverse effect during thetreatment with anti-TNF-α.While exclusion of anybacterial infection and screening for tuberculosis aremandatory before initiating a therapy with anti-TNF-α-antibodies,there are no guidelines whether to screenfor or how to deal with chronic viral infections such ashepatitis B.In this case report,we have described apatient with Crohn’s disease who developed subfulminanthepatitis B after the fourth infusion of infliximab due toan unrecognized HBs-antigen carrier state.He recoveredcompletely after lamivudine therapy was started,butthis severe adverse event could have been preventedif screening for HBV and pre-emptive therapy withlamivudine would have been started prior to infliximab.We therefore strongly argue in favor of extendedscreening recommendations for infectious diseasesincluding viral infections before considering a therapywith infliximab.
Infections are a major adverse effect during the treatment with anti-TNF-α. Whh Exclusion of any bacterial infection and screening for tuberculosis are mandatory before initiating a therapy with anti-TNF-α-antibodies, there are no guidelines whether to screen for or how to deal with chronic viral infections such as hepatopathy B. In this case report, we have described apatient with Crohn’s disease who developed subfulminanthepatitis B after the fourth infusion of infliximab due to unrecognized HBs-antigen carrier state. He recoveredcompletely after lamivudine therapy was started, butthis severe adverse event could have been preventedif screening for HBV and pre-emptive therapy withlamivudine would have been started prior prior to infliximab.We therefore strongly argue in favor of extendedscreening recommendations for infectious diseasesincluding viral infections before considering a therapy with infliximab.