Journal
RESPIROLOGY
Volume 15, Issue 7, Pages 1092-1097Publisher
WILEY
DOI: 10.1111/j.1440-1843.2010.01798.x
Keywords
asthma; chronic obstructive pulmonary disease; hepatitis B virus reactivation; inhaled corticosteroid; systemic corticosteroid
Categories
Funding
- Ministry of Health & Welfare, Republic of Korea [A040153, A030001]
- Korea Health Promotion Institute [A040153] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Background and objective: Reactivation of hepatitis B virus (HBV) is thought to be associated with immunosuppressive treatments, but insufficient information is available on the effect of corticosteroids. The aim of this study was to evaluate the risk of HBV reactivation in hepatitis B surface antigen-seropositive patients with asthma or COPD, who were treated with systemic corticosteroids (SCS) in addition to inhaled corticosteroids (ICS). Methods: Patients with asthma or COPD (n = 198), who were hepatitis B surface antigen-seropositive and had been treated with ICS, were identified retrospectively. To evaluate the additional effects of SCS, the SCS group was divided into those who received intermittent or continuous SCS (>= 3 months of continuous SCS treatment), and into those who received low-dose (<= 20 mg/day of prednisolone) or medium-to-high-dose SCS. The study outcome was HBV reactivation. Results: HBV reactivation occurred in 11.1% of patients in the SCS group, which was significantly higher than the reactivation rate in the ICS group. HBV reactivation was more frequent in the SCS group compared with the ICS group (OR 3.813, 95% CI: 1.106-13.145, P = 0.032), and in the continuous and medium-to-high-dose SCS subgroups compared with the ICS group (OR 5.719, 95% CI: 1.172-27.905, P = 0.048 and OR 4.884, 95% CI: 1.362-17.511, P = 0.014, respectively). Conclusions: These results suggest that addition of SCS to ICS increases the risk of HBV reactivation, especially when SCS are administered chronically or at high doses.
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