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Hepatitis B virus (HBV) infection can reactivate in patients who are receiving systemic corticosteroids. Receipt of inhaled or topical steroids, which result in lower systemic levels than oral steroids, is not typically thought of as a risk factor for HBV reactivation. However, a recent case report shows that we need to rethink this assumption.
An HIV-infected man with a history of prior HBV infection that was thought to have cleared (based on a negative HBV surface antigen [HBsAg] result and positive tests for antibodies against HBV surface antigen [anti-HBs] and HBV core antigen [anti-HBc]) was hospitalized with jaundice and elevated transaminase levels. At the time of admission, he was receiving inhaled fluticasone and triamcinolone for p…