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Yoshikazu Ogawa and Teiji Tominaga
Reactivation of hepatitis B virus (HBV) is a risk in the 350 million HBV carriers worldwide. HBV reactivation may cause hepatocellular carcinoma, cirrhosis, and fulminant hepatitis, and HBV reactivation accompanied with malignant tumor and/or chemotherapy is a critical problem for the patients with chronic HBV infection. In addition, multiple risk factors causing immunosuppressive state can also induce HBV reactivation, which includes a few cases of intrinsic cortisol over secretion as Cushing’s syndrome or very low-dose steroid treatment for hypopituitarism after pituitary surgeries.
Appropriate screening methods and the discussion for preventive supplementation of antiviral drugs for HBV reactivation are required. For patients with pituitary tumors precise operative procedures and careful treatment planning are essentially required to avoid HBV reactivation.