Published online Feb 16, 2016. doi: 10.12998/wjcc.v4.i2.49
Peer-review started: April 24, 2015
First decision: September 8, 2015
Revised: October 20, 2015
Accepted: November 10, 2015
Article in press: November 11, 2015
Published online: February 16, 2016
Up to date, in literature, it is still debated the role of anti-tumor necrosis factors (TNF)-α treatments in hepatitis C virus (HCV) patients. TNF-α performs a lot of functions, it is an important pro-inflammatory cytokine and it is involved in the host’s immunity. Since TNF-α is implicated in the apoptotic signaling pathway of hepatocytes infected by HCV, anti TNF-α therapy may increase the risk of viral replication or their reactivation. However the treatment of anti TNF-α could have a healthful role because TNF-α appears to be engaged in the pathogenesis of liver fibrosis, inducing apoptotic pathways. We describe the case of a patient with plaque-type psoriasis and concomitant chronic HCV, who was treated successfully with anti-TNF agents simultaneously to cyclosporine without sign of reactivation of HCV and increase of liver enzymes. Our personal experience shows that anti-TNF-α agents are not only effective but also safe. Furthermore the combination therapy of cyclosporine and anti-TNF-α appears to be well-tolerated and able to reduce the amount of liver enzymes as well as HCV-viral-load. However systematic, large-scale studies with long follow-ups will be needed to confirm our results, in association with close liver function monitoring.
Core tip: Our paper reports a patient with plaque-type psoriasis and concomitant chronic hepatitis C virus (HCV), focusing on the safety and efficacy of cyclosporine therapy and anti tumor necrosis factors-α agents. This therapeutic association is also able to decrease liver enzymes as well as HCV load with general clinical improvement. Our topic may be useful in the clinical setting of patients with simultaneous severe psoriasis and chronic HCV infection.