治疗SARS-CoV-2的并发症:与皮质类固醇相关的乙型肝炎再激活的风险

Jimena Varona Pérez, JM Rodriguez Chinesta
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摘要

已经导致使用所有可用的资源来控制这种疾病。随着我们对这种病毒的了解越来越多,我们开出了更有针对性的药物。炎症阶段可能是最令人担忧的。它需要减缓免疫系统激活的治疗方法[1]。皮质类固醇是最受欢迎的药物。然而,剂量和维持方案仍不确定。我们已经开始有一些关于其有效性的结果[2],这是一开始没有的。根据临床分析的严重程度,我们在我院使用了125或250毫克甲基强的松龙脉冲三天方案。然而,皮质类固醇并非没有风险。最常见的风险之一是感染的重新激活。乙型肝炎病毒的再激活尤其重要,因为它是经常发生的,我们可以预防它。此外,最近的一项研究将慢性HBV感染与SARS-CoV-2清除率降低联系起来[3]。因此,我们回顾了在接受皮质类固醇脉冲治疗的患者中预防HBV感染再激活的建议。
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Complications Of Treatment Against SARS-CoV-2: Risk Of Hepatitis B Reactivation Associated With Corticosteroids
has led to using all available resources to curb the disease. As we have learned more about the virus, more targeted drugs have been prescribed. The inflammation phase is perhaps the most worrisome. It requires therapies that slow down the immune system activation [1]. Corticosteroids are the favorite drug. However, dosages and maintenance regime are still uncertain. We have already started to have some results on its effectiveness [2], which were not available at the beginning. We have used a three-day regimen of 125 or 250 mg methylprednisolone pulses according to clinical-analytical severity in our hospital. However, corticosteroids are not without risks. One of the most frequent risks is the reactivation of infections. Reactivation of the hepatitis B virus is especially important because it is frequent and we can prevent it. In addition, a recent study has linked chronic HBV infection with a decreased clearance rate of SARS-CoV-2 [3]. Therefore, we review the recommendations on the prophylaxis of reactivation of HBV infection in patients receiving corticosteroid pulses.
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