Acute fulminant hepatitis B in a patient with diabetic nephropathy treated successfully with concomitant lamivudine and molecular adsorbents recirculating system

Tsai, Shih‐Hung; Chang, Hao‐Ming; Hsieh, Chung-Bao; Chao, You‐Chen; Hsieh, Tsai‐Yuan

doi:10.1016/j.jinf.2005.09.013

Cited by 4 publications

(8 citation statements)

References 17 publications

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“…Similar to our data , very good survival rates (mean survival rate almost 80%) in patients receiving lamivudine have been reported by others , whereas outcome without antiviral therapy has remained poor (see also Table ).…”

Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatsupporting

confidence: 92%

“…The definition of severe acute hepatitis B in the later study (38), but also in other similar studies (39,40), was according to the presence of at least two of the following three parameters: bilirubin levels more or equal to 10 mg/dl, International Normalized Ratio (INR) more or equal to 1.6 and the presence of hepatic encephalopathy. Similar to our data (38), very good survival rates (mean survival rate almost 80%) in patients receiving lamivudine have been reported by others (39,(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52), whereas outcome without antiviral therapy has remained poor (53-62) (see also Table 2).…”

Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatsupporting

confidence: 91%

“…Contrary to all previous mentioned studies , an article from India recruiting 71 patients with 31 (22/31 with severe acute HBV infection) receiving 100 mg lamivudine daily and 40 in the placebo group reported that lamivudine is of no use in severe acute hepatitis B. However, patients on lamivudine had significantly lower levels of HBV‐DNA (median: 3.7 log copies/ml vs. 4.3 log copies/ml; P = 0.04) at the week 4 visit while, tended to improve their serum bilirubin, ALT and INR values faster, although failed to reach level of significance .…”

Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatmentioning

confidence: 86%

“…As patients were receiving active lamivudine in case of failure to improve the authors could evaluate the early administration of lamivudine was crucial to patients not developing liver failure, independent of death (52). Contrary to all previous mentioned studies (38,39,(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52), an article from India (40) recruiting 71 patients with 31 (22/31 with severe acute HBV infection) receiving 100 mg lamivudine daily and 40 in the placebo group reported that lamivudine is of no use in severe acute hepatitis B. However, patients on lamivudine had significantly lower levels of HBV-DNA (median: 3.7 log copies/ml vs. 4.3 log copies/ml; P = 0.04) at the week 4 visit while, tended to improve their serum bilirubin, ALT and INR values faster, although failed to reach level of significance (40).…”

Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatmentioning

confidence: 99%

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Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Tillmann

Zachou

Dalekos

2011

Liver International

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Despite a decline in cases of acute hepatitis B and the low hepatitis B virus (HBV) chronicity rates in adults, still some patients progress to HBV‐related fulminant liver failure. In this review, we discuss treatment options that may prevent the progression of severe acute hepatitis B to fulminant liver failure and death. In severe acute HBV with prolonged prothrombin time and increased bilirubin, interferon failed to be effective while antiviral treatment, particularly with lamivudine, appears to improve survival (mean survival almost 80%). Outcome without antiviral therapy has remained considerably poor, whereas there is no convincing evidence of amelioration of HBV‐targeted immunity. Of note, most patients who died or required transplantation despite lamivudine therapy, were started on lamivudine at advanced stages compared with those survived. This suggests that prompt and timely antiviral therapy is crucial. Owing to the abovementioned results the design of randomized placebo‐control trials in the setting of severe acute hepatitis B seems unethical. On the contrary, the design of multicentre double‐blind randomized trials to compare the efficacy between lamivudine and entecavir or even tenofovir in acute severe HBV cases is ideally needed, but these studies appear to be very difficult to perform considering that these cases are not frequent and therefore, it is almost impossible to have two arms adequately numerous and homogenous for statistical evaluation. Thus, in the absence of solid evidence based data, the hepatologists could treat their patients with severe acute hepatitis B with lamivudine or the most potent antivirals entecavir or tenofovir.

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Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatsupporting

confidence: 92%

Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatsupporting

confidence: 91%

Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatmentioning

confidence: 86%

Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatmentioning

confidence: 99%

See 2 more Smart Citations

Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Tillmann

Zachou

Dalekos

2011

Liver International

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“…All three cases rapidly evolved from hepatitis flares to acute liver failure and death. Due to the high mortality rate, patients with rapid progression to liver failure should be evaluated for liver or combined liver-kidney transplantation 18 . This report has some limitations including the retrospective approach, recruitment bias and the fact that it is a small case-series.…”

mentioning

confidence: 99%

Post-transplant withdrawal of lamivudine results in fatal hepatitis flares in kidney transplant recipients, under immune suppression, with inactive hepatitis B infection

2017

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Objective: To evaluate the consequences of lamivudine withdrawal in kidney transplant recipients, under immunosuppression, with inactive hepatitis B virus (HBV) infection. Introduction: HBV infection is more frequent in kidney transplant recipients than in the general population mainly due to the high risk of acquisition during dialysis, before kidney transplantation. Methods: The records of hepatitis B surface antigen (HBsAg)-positive, immunosuppressed kidney transplant recipients, where lamivudine was withdrawn after transplantation along with reduction in immunosuppressant dose, admitted to our hospital between 2005 and 2012, were retrospectively evaluated. Discussion: Three patients aged 33, 42 and 33, experienced hepatitis flares 2-3 months after lamivudine withdrawal. Serum HBV DNA levels were 2.5×10 7 , 3.4×10 4 and 4×10 3 IU/ml in cases 1, 2, and 3, respectively. Lamivudine was re-initiated in all cases which led to rapid viral suppression. However, liver function continued to deteriorate leading to severe jaundice, coagulopathy and encephalopathy. All patients died of acute liver failure within six months after the onset of withdrawal hepatitis. Conclusion: Lamivudine should be continued as long as immunosuppressive therapy lasts.

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Gender Impacts on the Disease Severity of Overt Acute Hepatitis A: Different from Overt Acute Hepatitis B

Chang

Liaw

2018

Dig Dis Sci

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Acute fulminant hepatitis B in a patient with diabetic nephropathy treated successfully with concomitant lamivudine and molecular adsorbents recirculating system

Cited by 4 publications

References 17 publications

Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Post-transplant withdrawal of lamivudine results in fatal hepatitis flares in kidney transplant recipients, under immune suppression, with inactive hepatitis B infection

Gender Impacts on the Disease Severity of Overt Acute Hepatitis A: Different from Overt Acute Hepatitis B

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