Dumortier J, Durupt S, Chevallier M, Trépo C, Zoulim F
Service d'Hépatologie, Hôtel-Dieu, Lyon.
Gastroenterol Clin Biol. 1997;21(12):982-6.
Reactivation of hepatitis B virus replication is a rare event during the natural history of chronic hepatitis B. However, the clinical presentation may be severe and an effective therapeutic protocol must be established. We report a case of spontaneous reactivation of hepatitis B virus infection with liver failure. For the moment, no medical treatment has been defined in this situation. A combination of corticosteroids and antiviral drugs (foscarnet and ganciclovir) resulted in clinical and biological recovery, and HBV elimination. If the efficacy of this combined treatment is confirmed in a larger population, this new physiopathological approach should be considered whenever life threatening liver failure occurs.
乙型肝炎病毒复制再激活是慢性乙型肝炎自然病程中罕见的事件。然而，其临床表现可能很严重，必须建立有效的治疗方案。我们报告一例乙型肝炎病毒感染自发再激活伴肝衰竭的病例。目前，这种情况下尚无明确的药物治疗方法。皮质类固醇与抗病毒药物（膦甲酸钠和更昔洛韦）联合使用导致临床和生物学指标恢复，并清除了乙肝病毒。如果这种联合治疗的疗效在更大规模人群中得到证实，那么每当发生危及生命的肝衰竭时，都应考虑这种新的病理生理学治疗方法。
