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Lamivudine treatment for fulminant hepatic failure due to acute exacerbation of chronic hepatitis B infection
Author(s) -
Tsang S. W. C.,
Chan H. L. Y.,
Leung N. W. Y.,
Chau T. N.,
Lai S. T.,
Chan F. K. L.,
Sung J. J. Y.
Publication year - 2001
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2001.01107.x
Subject(s) - medicine , lamivudine , gastroenterology , fulminant hepatic failure , seroconversion , hepatitis b , exacerbation , hepatitis b virus , fulminant hepatitis , hepatitis , immunology , liver transplantation , transplantation , virus
Background: Exacerbation of chronic hepatitis B infection can lead to fulminant hepatic failure with a mortality of up to 90%. Aim: To evaluate the efficacy of lamivudine in the treatment of this subgroup of patients. Methods: Twenty‐four patients with exacerbation of chronic hepatitis B infection and fulminant hepatic failure were treated with lamivudine, 100 mg daily. Hepatitis A, C, D and human immunodeficiency virus co‐infections and hepatocellular carcinoma were excluded. Results: The median age was 53 years (range, 24–77 years) with a male predominance of 20:4. Seventeen patients were hepatitis B e antigen positive. Mean hepatitis B virus DNA was 2079 Meq/mL. Eight patients (33%) survived (group A). Thirteen patients died and three patients received liver transplantation (67%) (group B). Baseline laboratory results were comparable between the two groups, including serum albumin, bilirubin, alanine aminotransferase, prothrombin time and creatinine. Group B patients had significantly more comorbid illnesses at baseline and more complications, including sepsis and renal failure, compared with group A patients. Six out of eight survivors (75%) had full hepatitis B e antigen seroconversion, but this was not sustained in four patients. Conclusions: Lamivudine may be useful in treating patients with fulminant hepatic failure due to exacerbation of chronic hepatitis B. Hepatitis B e antigen seroconversion was less durable in this subgroup of patients and long‐term therapy may be required.