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. Hepatitis B virus (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 transaminases 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 to the care of these patients.

中文翻译：

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COVID-19和乙型肝炎感染。

由严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）引起的2019年冠状病毒疾病（COVID-19）已成为全球的主要负担，导致严重的公共卫生挑战。乙型肝炎病毒（HBV）感染是另一种广泛传播的病毒，长期感染约2.57亿人。在COVID-19大流行的背景下，HBV感染患者的治疗受到关注。COVID-19患者的肝脏受累程度不同，这是由对肝脏的直接病毒作用以及肝毒性药物引起的。肝酶水平升高证明了这一点，在严重SARS-CoV-2感染的患者中尤为明显。但是，关于患有潜在的慢性肝病（包括HBV感染）的COVID-19患者的管理方面，尚缺乏信息。研究表明用托珠单抗和皮质类固醇治疗后，HBV感染会重新激活，强调在使用这些药物治疗COVID-19 HBV感染患者时需要谨慎。转氨酶水平升高的患者以及高流行人群中应考虑HBV的筛查和预防。在患有晚期肝病的患者中，必须给予注意以最大程度地减少肝代偿失调的风险。然而，需要进一步的研究以使循证的方法来照顾这些患者。转氨酶水平升高的患者以及高流行人群中应考虑HBV的筛查和预防。在患有晚期肝病的患者中，必须给予注意以最大程度地减少肝代偿失调的风险。然而，需要进一步的研究以使循证的方法来照顾这些患者。转氨酶水平升高的患者以及高流行人群中应考虑HBV的筛查和预防。在患有晚期肝病的患者中，必须给予注意以最大程度地减少肝代偿失调的风险。然而，需要进一步的研究以使循证的方法来照顾这些患者。