Lamivudine is safe and effective in fulminant hepatitis B

Santantonio, T.; Mazzola, Michele; Pastore, G

doi:10.1016/s0168-8278(99)80119-6

Cited by 25 publications

(16 citation statements)

References 3 publications

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“…6 From the clinical perspective, the finding of massive reductions in HBV DNA during the incubation phase casts doubt on the logic of considering antiviral therapy as a means of reducing liver injury in immunocompetent patients who present in the clinical phase of acute or fulminant hepatitis B. 29 Based on these results we suggest that the incubation phase of HBV infection should be considered as the critical period for the interaction between host and pathogen. This is likely to be the time when viral control or persistence is determined.…”

Section: Discussionmentioning

confidence: 99%

Incubation Phase of Acute Hepatitis B in Man: Dynamic of Cellular Immune Mechanisms

et al. 2000

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After hepatitis B virus (HBV) infectionThe incubation period of a viral disease refers to the time between infection and the onset of symptoms, and has been believed to represent the phase of active viral replication before an effective host immune response. This period is generally long after infection with noncytopathic viruses such as hepatitis B virus (HBV), 1 in contrast to other viral diseases. [2][3][4] The development of symptoms, which may occur up to 6 months after HBV infection, 5 has been assumed to mark the onset of viral control by the immune system. 1 However, the observation of marked reductions in virus levels before liver injury in the chimpanzee model of HBV infection, 6 and of cytotoxic T lymphocyte (CTL)-mediated viral clearance in the absence of cytolysis, in a transgenic mouse model of HBV infection, 7 has challenged the evidence that HBV control is predominantly caused by CTL-mediated tissue injury. It is, therefore, possible that immunologic events important for the control of HBV may already be present during the long incubation phase of primary infection. However, patients are usually only diagnosed after the development of symptoms: thus, it has been difficult to study the relationship between viral dynamics and liver injury, and whether the incubation phase of HBV infection in humans represents a period of ongoing viral replication in the presence of a deficient immune response. 8 During a single-source outbreak of HBV infection, in which 30 patients were infected through a skin-piercing procedure known as autohemotherapy, 9 a number of patients were identified before the onset of clinical hepatitis. The recent development of immunologic techniques to directly quantify virusspecific lymphocytes, 10,11 enabling the dynamics of CD8 and CD4 responses during viral infections to be investigated, provided a unique opportunity to study the interaction among virus, clinical disease, and host immune responses from the incubation phase of acute HBV infection. PATIENTS AND METHODS Patients.Five patients (all women, mean age 54 years, range 37-71) were identified during the incubation phase of acute hepatitis B, and were longitudinally followed up through the course of the disease. Their infection was diagnosed on the basis of finding a positive serum hepatitis B surface antigen (HBsAg), HBV DNA by polymerase chain reaction, normal or minimally raised serum alanine transaminase (ALT) levels, a marker of hepatocyte damage, 12 and no symptoms of clinical acute hepatitis. Each patient was infected with the same variant of HBV, as assessed by viral genome sequencing and

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Section: Discussionmentioning

confidence: 99%

Incubation Phase of Acute Hepatitis B in Man: Dynamic of Cellular Immune Mechanisms

et al. 2000

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“…Recently, nucleoside analogues (NAs) have been administered safely even in severe disease [9][10][11][12][13], and in our previous studies, we reported that the introduction of high-dose CS and NA could significantly reverse deterioration in patients with ''clinically severe, life-threatening'' exacerbation of chronic hepatitis B compared with historical controls, when used in the early stage of the illness [14,15]. But the dose and the period of CS use have still to be clarified.…”

Section: Introductionmentioning

confidence: 99%

The requirement for a sufficient period of corticosteroid treatment in combination with nucleoside analogue for severe acute exacerbation of chronic hepatitis B

et al. 2010

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“…Interferon and lamivudine are beneficial not only for chronic hepatitis but also for FHF. 7,10 In our patient, serial PCR assays showed that the HBV viremia was alleviated and HBV clearance occurred 2 months after the onset of encephalopathy, despite the use of the steroid.…”

Section: Discussionmentioning

confidence: 57%

HBV-related fulminant hepatic failure: successful intensive medical therapy in a candidate for liver transplantation

Masuhara

Yagawa

Aoyagi

et al. 2001

Journal of Gastroenterology

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Fulminant hepatic failure (FHF) usually has a fatal prognosis without liver transplantation. We describe the case of a woman who developed FHF, and was evaluated as a candidate for liver transplantation, but who was cured without transplantation through intensive medical care that included glucagon-insulin therapy, methylprednisolone pulse therapy, interferon beta and lamivudine administration, cyclosporine administration, and high-volume hemodiafiltration and plasma exchange. In a patient with FHF who is a candidate for liver transplantation but for whom the transplantation cannot be performed for some reason, intensive medical therapy, including regeneration-promoting therapy, immunosuppressive therapy, antiviral therapy, and vigorous hepatic support, should be carried out.

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Lamivudine is safe and effective in fulminant hepatitis B

Cited by 25 publications

References 3 publications

Incubation Phase of Acute Hepatitis B in Man: Dynamic of Cellular Immune Mechanisms

Incubation Phase of Acute Hepatitis B in Man: Dynamic of Cellular Immune Mechanisms

The requirement for a sufficient period of corticosteroid treatment in combination with nucleoside analogue for severe acute exacerbation of chronic hepatitis B

HBV-related fulminant hepatic failure: successful intensive medical therapy in a candidate for liver transplantation

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