糖皮质激素致乙型肝炎病毒再激活死亡1例报道

Death due to reactivation of hepatitis B virus caused by glucocorticoid:one case report

我国是乙型肝炎病毒(HBV)感染高流行区,HBV感染者在接受免疫抑制剂或细胞毒性药物治疗期间或之后,可能出现不同程度的HBV再激活,死亡率较高。预防性应用拉米夫定等抗乙肝病毒药物可有效降低HBV再激活发生率和死亡率。本文报道1例糖皮质激素治疗致HBV再激活死亡的病例,并结合文献复习,探讨并提高对HBV再激活的发生率、危险因素、诊断及治疗等的认识。

Hepatitis B virus（HBV） infection is an important medical and public health concern.Patients with hepatitis B are at risk of viral reactivation when undergoing cytotoxic or immunosuppressive chemotherapy for malignancies.The condition ranges from asymptomatic self-limiting anicteric hepatitis to severe, potentially fatal progressive decompensated hepatitis.Prophylactic therapy with nucleoside analogues has been shown to significantly decrease the incidence and overall morbidity of HBV reactivation.Here we report a case of fatal hepatic failure due to HBV reactivation that manifested during immunosuppressive therapy of glucocorticoid in a patient with myasthenia gravis.Besides this case report,we consider the incidence,diagnosis,risk factors,prevention and management of HBV reactivation.