Short-Course Steroids Trigger HBV Reactivation in COVID-19
This retrospective cohort suggests that even brief high-dose corticosteroid exposure can reactivate hepatitis B in HBsAg-positive COVID-19 patients, reinforcing the case for pre-treatment screening and prophylaxis.
corticosteroidsmethylprednisoloneentecavirtenofovirnucleos(t)ide analogueshepatitis B virusHBV reactivationCOVID-19retrospective cohortantiviral prophylaxishepatologyGastroenterology / Hepatology
Background Information
Screen for HBV before giving corticosteroids to COVID-19 patients.
COVID-19 patients with hepatitis B virus (HBV) infection treated with corticosteroids may experience HBV reactivation (HBVr), leading to severe outcomes. HBVr occurred in 7 out of 145 patients, with higher steroid doses linked to reactivation. Two patients developed hepatic failure and died. Routine HBV screening and antiviral prophylaxis should precede corticosteroid therapy in regions with significant HBV prevalence to prevent potentially fatal HBVr. COVID-19 patients with HBV should be screened and potentially receive prophylaxis before corticosteroid treatment to prevent HBVr.
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Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
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