Clin Mol Hepatol.  2012 Jun;18(2):225-228. 10.3350/cmh.2012.18.2.225.

A fatal case of hepatitis B virus (HBV) reactivation during long-term, very-low-dose steroid treatment in an inactive HBV carrier

• Bae JH
• Sohn JH
• Lee HS
• Park HS
• Hyun YS
• Kim TY
• Eun CS
• Jeon YC
• Han DS

• KMID: 1743731
• DOI: http://doi.org/10.3350/cmh.2012.18.2.225

Abstract

Hepatitis B virus (HBV) may be reactivated after chemotherapy or immunosuppressive therapy, and therefore administration of antiviral agents before such treatment is recommended. Most reported cases of reactivation are associated with high doses of immunosuppressive agents or combination therapy. We present a case of a previously inactive HBV carrier with an acute severe flare-up during a long-term, very-low-dose (2.5 mg/day) steroid treatment for rheumatoid arthritis. We suggest that even a minimal dose of single-regimen oral steroid can cause reactivation of indolent, inactive HBV.

Keyword

Hepatitis B virus; Liver failure; Steroids; Virus activation

MeSH Terms

Aged, 80 and over
Antiviral Agents/therapeutic use
Arthritis, Rheumatoid/drug therapy
DNA, Viral/analysis
Female
Hepatitis B/*drug therapy
Hepatitis B Surface Antigens/blood
Hepatitis B virus/genetics
Humans
Immunosuppressive Agents/*therapeutic use
Steroids/*therapeutic use
Tomography, X-Ray Computed
Treatment Outcome
Virus Activation