The Study of Efficacy of Lamivudine in Patients with Severe Acute Hepatitis B

Abstract

Early treatment with lamivudine leads to a greater decrease in HBV DNA level, better clinical improvement and mortality improvement in patients with severe acute hepatitis B, but with a lower seroconversion rate. A rapid decline of HBV DNA load is a good predictor for the treatment outcome.

Acute Liver Failure in Adults: Etiology, Clinical Manifestations, Methods of Correction

“…К настоящему времени доказательная база включа-ет результаты нескольких исследований, которые обосновывают преимущества назначения анало-гов нуклеоз(т)идов (АН). В одном из них было про-демонстрировано, что при включении в терапию ламивудина для пациентов с тяжелым ОГВ, зна-чительно снизились, по сравнению с контрольной группой, процент летальных исходов (7,5% про-тив 25%) и частота развития ОПН (20% против 42,5%) [59]. В других исследованиях -подтверж-дены преимущества назначения (улучшение про-гноза) и безопасность ламивудина при лечении па-циентов с острым тяжелым или фульминантным гепатитом В [60].…”

Entecavir in Severe Acute Hepatitis B

“…Yu et al [59] studied the efficacy of lamivudine in patients with severe acute hepatitis B and concluded that early treatment with lamivudine leads to a greater decrease in HBV DNA level, better clinical improvement and mortality improvement in patients with severe acute hepatitis B and also decreases the progression to hepatic failure. More potent antiviral drugs such as Entecavir and tenofovir are now available.…”

“…Entecavir has been tried in many case reports and case series of severe acute hepatitis B with excellent results [59][60][61].…”

Letter: acute hepatitis B – to treat or not to treat?

“…The first randomised clinical trial was carried out 3 years later and included a total of 71 patients with AHB (31 randomised to lamivudine for 3 months and 40 to placebo) and showed no biochemical or clinical benefit to lamivudine; the lack of response to therapy was observed in the subset of 47 patients of the study with the diagnosis of severe AHB. 4 By contrast, Yu et al, 5 conducted a more recent clinical trial that included 80 AHB patients, and showed statistically significant differences in mortality (7.5% lamivudine AP&T invited commentary and correspondence columns are restricted to letters discussing papers that have been published in the journal. A letter must have a maximum of 300 words, may contain one table or figure, and should have no more than 10 references.…”

“…1 It is believed that plasmocytoid dendritic cells (natural IFN-a producers) are capable of inducing psoriasis through IFN-a production. 4,5 Since such plasmocytoid cells are usually down-regulated by TNF-a, its inhibition by the biological may determine increased and uncontrolled IFN-a production and consequently induce or exacerbate psoriasis. 6 In the literature, in addition to the in vitro studies described by the authors, 1 there are other reports 3, 7 that support such a relationship between IFN-a and anti-TNF-a-induced psoriasiform lesions.…”