Lamivudine treatment for fulminant hepatic failure due to acute exacerbation of chronic hepatitis B infection.

Abstract

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.

• Authors: S W Tsang, H L Chan, N W Leung, T N Chau, S T Lai, F K Chan, J J Sung
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 15 Issue 11 Pg. 1737-44 (Nov 2001) ISSN: 0269-2813 [Print] England
• PMID: 11683687 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Hepatitis B e Antigens
• Reverse Transcriptase Inhibitors
• Lamivudine

Topics

• Administration, Oral
• Adult
• Aged
• Comorbidity
• Female
• Hepatitis B e Antigens (analysis, immunology)
• Hepatitis B, Chronic (complications)
• Humans
• Lamivudine (pharmacology)
• Liver (enzymology, pathology)
• Liver Failure (drug therapy, etiology)
• Male
• Middle Aged
• Reverse Transcriptase Inhibitors (pharmacology)
• Treatment Outcome