Baroiu Liliana, Anghel Lucreția, Laurențiu Tatu Alin, Iancu Alina Viorica, Dumitru Caterina, Leșe Ana-Cristina, Drăgănescu Miruna, Năstase Florentina, Niculeț Elena, Fotea Silvia, Nechita Aurel, Voinescu Doina Carina, Stefanopol Anca Ioana
Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania.
Department of Infectious Diseases 'Sf. Cuv. Parascheva' Clinical Infectious Diseases Hospital, 800179 Galati, Romania.
Exp Ther Med. 2022 Jun;23(6):385. doi: 10.3892/etm.2022.11312. Epub 2022 Apr 12.
The cytokine storm from the evolution of severe cases of COVID-19, requiring strong immunosuppressive therapies, has raised the issue of reactivation of hepatitis B virus (HBV) infections in these patients. An analysis of the first observational studies in patients with COVID-19 and immunosuppressive therapy and HBV infection along with special clinical cases was presented, as well as personal experience on a series of cases (a group of 958 patients with COVID-19), compared with the analysis of studies performed on patients with HBV infection that underwent biological therapies for psoriasis and personal experience (a group of 81 psoriasis patients treated with biological therapies). Clinical studies have revealed that HBV reactivation in patients undergoing biological therapies for psoriasis, can be prevented with monitoring and treatment protocols and thus, these therapies have been demonstrated to be safe and effective. In COVID-19, immunosuppressive therapies are short-lived but in high doses, and the conclusions of clinical trials are contradictory, but there are published cases of HBV reactivation, which requires a unitary attitude in the prevention of HBV reactivation in these patients. An algorithm was presented for monitoring and treatment of HBV infection for patients with psoriasis treated with biological therapy and the conditions when this protocol can be used for patients with COVID-19 and immunosuppressive therapy.
新冠重症病例病情进展引发的细胞因子风暴，需要强效免疫抑制治疗，这引发了此类患者乙肝病毒（HBV）感染再激活的问题。本文介绍了对新冠、免疫抑制治疗及HBV感染患者的首批观察性研究分析以及特殊临床病例，还介绍了一系列病例（958例新冠患者组）的个人经验，并与针对接受生物疗法治疗银屑病的HBV感染患者的研究分析及个人经验（81例接受生物疗法治疗的银屑病患者组）进行了比较。临床研究表明，接受生物疗法治疗银屑病的患者中，通过监测和治疗方案可预防HBV再激活，因此已证明这些疗法安全有效。在新冠患者中，免疫抑制治疗持续时间短但剂量高，临床试验结论相互矛盾，但已有HBV再激活的病例报道，这就需要对预防此类患者的HBV再激活采取统一的态度。本文提出了一种针对接受生物疗法治疗的银屑病患者HBV感染的监测和治疗算法，以及该方案可用于新冠及免疫抑制治疗患者的条件。
