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Rituximab hepatitis B — SCE Rheumatology MCQ

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ModerateRheumatological pharmacologyRituximab hepatitis BSCE Rheumatology

A 54-year-old man with RA is due rituximab but screening shows anti-HBc positive status. Examination shows he has no liver symptoms. Investigations show HBsAg is negative and HBV DNA is pending. What is the most appropriate management?

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Correct answer: B — Seek hepatology advice and plan antiviral prophylaxis or monitoring

Seek hepatology advice and plan antiviral prophylaxis or monitoring is the safest management step for this treatment-related scenario. The alternatives either continue a potentially harmful drug, omit essential monitoring, or address the wrong risk. Shared-care DMARD prescribing depends on clear monitoring thresholds and rapid communication with rheumatology.

Reference: BNF; SPS DMARD monitoring guidance; BSR DMARD prescribing guideline