Treatment with lamivudine and entecavir in severe acute hepatitis B.

Abstract

BACKGROUND:

Severe acute hepatitis B (SAHB) is an insufficiently described clinical entity, with relatively scarce data on anti-viral therapy available in field literature.

METHODS:

We performed an open-label study to evaluate specific anti-viral therapy in SAHB in Bucharest, Romania, during 2005-2009. Patients were allocated to two treatment groups and one control group: Group 1 - lamivudine 100 mg/day, Group 2 - entecavir 0.5 mg/day and Group 3 - standard of care, without anti-viral therapy. The primary endpoint was hepatitis B surface antigen (HBsAg) to hepatitis B surface antibody (anti-HBs) seroconversion by 24 weeks. Additional analyses included assessment of HBsAg clearance and hepatitis B e antigen (HBeAg) to hepatitis B e antibody (anti-HBe) seroconversion.

RESULTS:

In Group 1, 7/69 patients (10.14%, P = 0.032) reached HBsAg/Ab seroconversion by 24 weeks, compared with 9/21 (42.85%, P = 0.053) in Group 2 and 25/110 (22.72%) in Group 3. HBsAg clearance by 24 weeks: 16/69 patients (23.18%, P = 0.027) in Group 1, 11/21 (52.38%, P = 0.256) in Group 2 and 43/110 (39.09%) in Group 3. HBeAg/Ab seroconversion: 46/61 (75.40%, P = 0.399) in Group 1, 9/19 (47.36%, P = 0.001) in Group 2 and 74/100 (74.00%) in Group 3.

CONCLUSION:

Anti-viral therapy can be considered for managing selected cases of SAHB. Biochemical as well as virological parameters need to orient the choice of the anti-viral agent. Lamivudine displayed a greater decrease in viral load compared to controls, but it was associated with lower levels of HBsAg to anti-HBs seroconversion. Patients treated with entecavir showed a better response in terms of HBs seroconversion by 24 weeks.

• Authors: A Streinu-Cercel, O Sandulescu, M Stefan, A Streinu-Cercel
• Journal: Indian journal of medical microbiology (Indian J Med Microbiol) 2016 Apr-Jun Vol. 34 Issue 2 Pg. 166-72 ISSN: 1998-3646 [Electronic] United States
• PMID: 27080767 (Publication Type: Clinical Study, Journal Article)

Chemical References

• Antiviral Agents
• Hepatitis B Antibodies
• Hepatitis B Surface Antigens
• Lamivudine
• entecavir
• Guanine

Topics

• Adult
• Antiviral Agents (administration & dosage)
• Female
• Guanine (administration & dosage, analogs & derivatives)
• Hepatitis B (drug therapy)
• Hepatitis B Antibodies (blood)
• Hepatitis B Surface Antigens (blood)
• Humans
• Lamivudine (administration & dosage)
• Male
• Middle Aged
• Prospective Studies
• Romania
• Treatment Outcome
• Viral Load