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      전신홍반루푸스 환자에서 Corticosteroids 복용 중에 B형 간염이 활성화한 1예 = A Case of Reactivation of Hepatitis B Virus during Cortiocosteroids Treatment in the Patient with Systemic Lupus Erythematosus

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      https://www.riss.kr/link?id=A60108032

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      다국어 초록 (Multilingual Abstract)

      Hepatitis B virus (HBV) infection is endemic in Asia and reactivation of HBV is a well recognized complication in infected patients who undergo cytotoxic chemotherapy for cancer and immunosuppressive therapy. Since immunosuppressant can facilitate vir...

      Hepatitis B virus (HBV) infection is endemic in Asia and reactivation of HBV is a well recognized complication in infected patients who undergo cytotoxic chemotherapy for cancer and immunosuppressive therapy. Since immunosuppressant can facilitate viral replication and lead to reactivation of HBV, the management of systemic lupus erythematosus (SLE) patients who are HBsAg-positive presents a clinical challenge. We report here on a 29-year old female with SLE and HBsAg positivity who presented hepatitic flare during corticosteroid treatment only. HBsAg carriers who receive cytotoxic or immunosuppressive therapy are at considerable risk of reactivation of HBV infection. Antiviral prophylaxis is clinically efficacious as primary prophylaxis to prevent HBV reactivation. Risk factors allowing patient stratification for HBV reactivation include foremost the HBV DNA level before initiation of immunosuppresive treatment, including corticosteroids. Monitoring for development of acute flare of HBV should be performed by serial measurement of HBV DNA and liver enzymes regularly.

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      참고문헌 (Reference) 논문관계도

      1 Tur-Kaspa R, "The glucocorticoid receptor recognizes a specific nucleotide sequence in hepatitis B virus DNA causing increased activity of the HBV enhancer" 1988

      2 Cheng AL, "Steroid-free chemotherapy decreases risk of hepatitis B virus (HBV) reactivation in HBV-carriers with lymphoma" 2003

      3 Chi ZC, "Rheumatologic manifestations of hepatic diseases" 2003

      4 Vento S, "Reactivation of replication of hepatitis B and C viruses after immunosuppressive therapy: an unresolved issue" 2002

      5 Lok AS, "Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy.Report of a prospective study" 1991

      6 Thong BY, "Outcomes of chronic hepatitis B infection in Oriental patients with rheumatic diseases" 2007

      7 Sakamaki H, "Hepatitis B virus reactivation in a patient with chronic GVHD after allogeneic peripheral blood stem cell transplantation" 2001

      8 Lavanchy D, "Hepatitis B virus epidemiology,disease burden, treatment, and current and emerging prevention and control measures" 2004

      9 Calabrese LH, "Hepatitis B virus (HBV) reactivation with immunosuppressive therapy in rheumatic diseases: assessment and preventive strategies" 2006

      10 Lu CL, "Hepatitis B infection and changes in interferon-alpha and -gamma production in patients with systemic lupus erythematosus in Taiwan" 1997

      1 Tur-Kaspa R, "The glucocorticoid receptor recognizes a specific nucleotide sequence in hepatitis B virus DNA causing increased activity of the HBV enhancer" 1988

      2 Cheng AL, "Steroid-free chemotherapy decreases risk of hepatitis B virus (HBV) reactivation in HBV-carriers with lymphoma" 2003

      3 Chi ZC, "Rheumatologic manifestations of hepatic diseases" 2003

      4 Vento S, "Reactivation of replication of hepatitis B and C viruses after immunosuppressive therapy: an unresolved issue" 2002

      5 Lok AS, "Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy.Report of a prospective study" 1991

      6 Thong BY, "Outcomes of chronic hepatitis B infection in Oriental patients with rheumatic diseases" 2007

      7 Sakamaki H, "Hepatitis B virus reactivation in a patient with chronic GVHD after allogeneic peripheral blood stem cell transplantation" 2001

      8 Lavanchy D, "Hepatitis B virus epidemiology,disease burden, treatment, and current and emerging prevention and control measures" 2004

      9 Calabrese LH, "Hepatitis B virus (HBV) reactivation with immunosuppressive therapy in rheumatic diseases: assessment and preventive strategies" 2006

      10 Lu CL, "Hepatitis B infection and changes in interferon-alpha and -gamma production in patients with systemic lupus erythematosus in Taiwan" 1997

      11 Bertoletti A, "HLA class I-restricted human cytotoxic T cells recognize endogenously synthesized hepatitis B virus nucleocapsid antigen" 1991

      12 Chou CK, "Glucocorticoid stimulates hepatitis B viral gene expression in cultured human hepatoma cells" 1992

      13 Kohrt HE, "Antiviral prophylaxis for chemotherapy-induced reactivation of chronic hepatitis B virus infection" 2007

      14 Perrillo RP, "Acute flares in chronic hepatitis B: the natural and unnatural history of an immunologically mediated liver disease" 2001

      15 Geier DA, "A case-control study of serious autoimmune adverse events following hepatitis B immunization" 2005

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