Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2016; 4(2): 49-55
Published online Feb 16, 2016. doi: 10.12998/wjcc.v4.i2.49
Safety and efficacy of anti-tumor necrosis factors α in patients with psoriasis and chronic hepatitis C
Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta
Monica Salvi, Laura Macaluso, Cecilia Luci, Carlo Mattozzi, Giovanni Paolino, Yvonne Aprea, Stefano Calvieri, Antonio Giovanni Richetta, Department of Dermatology and Venerology, Policlinico Umberto I, 00161 Rome, Italy
Author contributions: All authors contributed to the acquisition of data, writing and revision of the manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board Standards of the Department of Dermatology at La Sapienza University of Rome.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have not conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Monica Salvi, MD, Department of Dermatology and Venerology, Policlinico Umberto I, viale del Policlinico 155, 00161 Rome, Italy. monica.slv@hotmail.it
Telephone: +39-333-2576530 Fax: +39-06-4462104
Received: April 23, 2015
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
Abstract

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.

Keywords: Hepatitis C virus infection, Cyclosporine, Psoriasis, Safety, Anti-tumor necrosis factors-α agents

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.