COVID-19 and hepatitis B infection.

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Antiviral Therapy Pub Date : 2020-01-01 DOI:10.3851/IMP3382
Saleh A Alqahtani, Maria Buti
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引用次数: 20

Abstract

The 2019 coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a major burden worldwide, resulting in serious public health challenges. HBV infection is another widely spread virus that chronically affects about 257 million people. The management of patients with HBV infection has gained attention in the context of the COVID-19 pandemic. Patients with COVID-19 have varying levels of liver involvements, resulting from direct viral effects on the liver as well as hepatotoxic drugs. This was demonstrated by elevated levels of liver enzymes, particularly evident in those patients with severe SARS-CoV-2 infection. However, scarce information is available on the management of COVID-19 patients having an underlying chronic liver disease, including HBV infection. Studies have shown reactivation of HBV infection following treatment with tocilizumab and corticosteroids, emphasizing the need for caution when using these agents to treat COVID-19 patients with HBV infection. HBV screening and prophylaxis should be considered in patients with elevated transaminase levels and also in high prevalence populations. In patients with advanced liver disease, attention must be given to minimize the risk of liver decompensation. Nevertheless, further investigation is needed to enable an evidence-based approach for the care of these patients.

COVID-19和乙型肝炎感染。
由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的2019年冠状病毒病(COVID-19)已成为全球的主要负担,造成严重的公共卫生挑战。乙型肝炎病毒感染是另一种广泛传播的病毒,慢性影响约2.57亿人。在COVID-19大流行背景下,HBV感染患者的管理受到关注。由于病毒对肝脏的直接作用以及肝毒性药物,COVID-19患者的肝脏受到不同程度的损害。肝酶水平升高证明了这一点,在严重的SARS-CoV-2感染患者中尤其明显。然而,关于有潜在慢性肝病(包括HBV感染)的COVID-19患者的管理信息匮乏。研究表明,使用托珠单抗和皮质类固醇治疗后HBV感染会再激活,强调使用这些药物治疗合并HBV感染的COVID-19患者时需要谨慎。在转氨酶水平升高的患者和高流行人群中,应考虑进行HBV筛查和预防。对于晚期肝病患者,必须注意将肝功能失代偿的风险降至最低。然而,需要进一步的调查,以使这些患者的护理循证方法。
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来源期刊
Antiviral Therapy
Antiviral Therapy 医学-病毒学
CiteScore
2.60
自引率
8.30%
发文量
35
审稿时长
4-8 weeks
期刊介绍: Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.
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