P386. Refractory inflammatory bowel disease, treated with anti-TNF agents in patients with hepatitis C
I. Gubonina1, A. Pershko1, A. Dragun2, 1Military Medical Academy, 2nd Therapy Dpt, St-Petersburg, Russian Federation, 2International Medical Centre “Sogaz”, Out-patient department, St-Petersburg, Russian Federation
Data on the frequency of liver dysfunction in patients with inflammatory bowel disease (IBD) treated with Anti-TNF agents and infected with hepatitis C virus are limited.
Ten patients (four men, six women and aged 28–45) with refractory IBD and HCV infection were included in our department between 2005 and 2012. Clinical records were reviewed for the type and duration of therapy used, liver function tests and viral markers before, during and after treatment.
All patients had refractory IBD and HCV markers (HCV-RNA positive). Six patients suffered from Crohn's disease and four patients from ulcerative colitis. All patients were treated with infliximab 5 mg/kg every 8 weeks after undergoing induction at weeks 0, 2 and 6. The duration of infliximab therapy was from 8 to 24 months. 9 of 10 patients received combination of infliximab and immunosuppressant (azathyoprine 2.5 mg/kg/day). All patients treated with infliximab experienced sustained improvement of their IBD symptoms, 3 patients reached clinical remission.
Liver dysfunction was observed in 2 of 10 HCV-RNA positive patients (20%), both of them received combined infliximab and azathyoprine therapy. None of them progressed with hepatic failure. During anti-TNF therapy, none of the patients experienced HCV reactivation.
Anti-TNF therapy appears to be safe and effective for treating refractory IBD in patients with HCV infection.