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      • 전신홍반루푸스 환자에서 Corticosteroids 복용 중에 B형 간염이 활성화한 1예

        곽지영 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.3/4

        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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