Abstract | BACKGROUND: METHODS: Twenty-five patients with spontaneous severe acute exacerbation (accompanied by jaundice and coagulopathy) were consecutively treated with lamivudine. Their clinical outcomes were compared with those of 25 lamivudine-untreated patients, as historical controls. RESULTS: Six lamivudine-treated patients (24%)and seven controls (28%) rapidly developed hepatic failure. Lamivudine monotherapy did not significantly prevent progression to hepatic failure. Multivariate analysis identified baseline serum bilirubin >/=6 mg/dL (odds ratio [OR]: 5.61; 95% confidence interval [CI]: 1.66-21.61; P = 0.018), pre-existing cirrhosis (OR: 4.52; 95%CI: 1.26-30.42; P = 0.034), and baseline prothrombin time <40% (OR: 3.75; 95%CI: 1.03-43.86; P = 0.045) as independent determinants of the event. Of the aforementioned patients with hepatic failure, three lamivudine-treated patients (50%) and two controls (29%) survived (P > 0.15). However, lamivudine induced a sustained normalization of liver function and inhibited the development of cirrhosis in survivors. CONCLUSIONS:
Lamivudine monotherapy conferred no significant protection against rapid progression of the disease to hepatic failure, but it resulted in long-term benefits. Lamivudine combined with other drugs could be more beneficial for patients with the aforementioned risk factors.
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Authors | Akihito Tsubota, Yasuji Arase, Yoshiyuki Suzuki, Fumitaka Suzuki, Hitomi Sezaki, Tetsuya Hosaka, Norio Akuta, Takashi Someya, Masahiro Kobayashi, Satoshi Saitoh, Kenji Ikeda, Hiromitsu Kumada |
Journal | Journal of gastroenterology and hepatology
(J Gastroenterol Hepatol)
Vol. 20
Issue 3
Pg. 426-32
(Mar 2005)
ISSN: 0815-9319 [Print] Australia |
PMID | 15740488
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Biomarkers
- DNA, Viral
- Hepatitis B Surface Antigens
- Reverse Transcriptase Inhibitors
- Lamivudine
- Transaminases
- Bilirubin
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Topics |
- Acute Disease
- Administration, Oral
- Adult
- Bilirubin
(blood)
- Biomarkers
(blood)
- DNA, Viral
(blood)
- Disease Progression
- Female
- Hepatitis B Surface Antigens
(blood)
- Hepatitis B virus
(genetics, immunology)
- Hepatitis B, Chronic
(blood, complications, drug therapy)
- Humans
- Lamivudine
(administration & dosage, therapeutic use)
- Liver
(diagnostic imaging)
- Liver Failure, Acute
(diagnosis, etiology, prevention & control)
- Male
- Middle Aged
- Prognosis
- Radiography
- Recurrence
- Retrospective Studies
- Reverse Transcriptase Inhibitors
(administration & dosage, therapeutic use)
- Severity of Illness Index
- Transaminases
(blood)
- Treatment Outcome
- Ultrasonography
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