Treatment of psoriasis with efalizumab in patients with hepatitis C viral infection: report of five cases

Background: Concomitant hepatitis C virus infection (HCV) needs caution when selecting systemic treatments in psoriasis patients as some agents confer a risk of liver toxicity and/or are immunosuppressant. Phototherapy may provide a therapeutic choice but it is not always a practical option. Limited evidence supports the use of cyclosporine or TNF-α blockers. No data are available concerning the safety of efalizumab in patients with HCV infection. Objective: To describe the clinical characteristics and evolution of 5 adult patients with severe chronic plaque psoriasis and concomitant HCV infection who were treated with efalizumab. Method: A retrospective clinical case report. Results: Five adult patients with severe chronic plaque psoriasis and concomitant HCV infection were treated successfully using efalizumab with no increased viral replication and progression of liver disease for a follow-up of 8–20 months. Conclusion: Although further confirmation is needed, this report provides preliminary evidence to support also a cautious use of efalizumab in patients with HCV infection.