The Ultra-Short Virological Dynamics in Response to Entecavir or Lamivudine during Chronic Hepatitis B with Spontaneous Severe Acute Exacerbation

Lee, Teng‐Yu; Chen, Chi-Yi; Lia, Hsueh-Chou; Hsu, Yu-Chung; Yang, Sheng‐Shun

doi:10.3851/imp3183

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…We were not able to evaluate the predictive role of dynamic changes in HBV DNA as the short term changes in HBV DNA were not routinely measured in clinical practice. Although a few studies found that viral kinetics can predict the severity of AE in patients with CHB[32], a recent study showed that in patients with spontaneous SAE of CHB, either lamivudine or entecavir could induce a rapid decline of HBV viral load[38]. Second, the patients in this study were admitted from January 2011 to August 2018; although all patients received standard conservative therapy upon admission, the treatment methods may be different among the patients with SAE before admission.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for progression to acute-on-chronic liver failure during severe acute exacerbation of chronic hepatitis B virus infection

Yuan¹,

Zeng²,

Liu³

et al. 2019

WJG

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BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus (HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation (HD) and acute-on-chronic liver failure (ACLF) in patients with severe acute exacerbation (SAE) of chronic HBV infection remain unknown. AIM To identify risk factors related to progression to HD and ACLF in compensated patients with SAE of chronic HBV infection. METHODS The baseline characteristics of 164 patients with SAE of chronic HBV infection were retrospectively reviewed. Independent risk factors associated with progression to HD and ACLF were identified. The predictive values of our previously established prediction model in patients with acute exacerbation (AE model) and the model for end-stage liver disease (MELD) score in predicting the development of ACLF were evaluated. RESULTS Among 164 patients with SAE, 83 (50.6%) had compensated liver cirrhosis (LC), 43 had progression to HD without ACLF, and 29 had progression to ACLF within 28 d after admission. Independent risk factors associated with progression to HD were LC and low alanine aminotransferase. Independent risk factors for progression to ACLF were LC, high MELD score, high aspartate aminotransferase (AST) levels, and low prothrombin activity (PTA). The area under the receiver operating characteristic of the AE model [0.844, 95% confidence interval (CI): 0.779-0.896] was significantly higher than that of MELD score (0.690, 95%CI: 0.613-0.760, P < 0.05) in predicting the development of ACLF. CONCLUSION In patients with SAE of chronic HBV infection, LC is an independent risk factor for progression to both HD and ACLF. High MELD score, high AST, and low PTA are associated with progression to ACLF. The AE model is a better predictor of ACLF development in patients with SAE than MELD score.

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Section: Discussionmentioning

confidence: 99%

Risk factors for progression to acute-on-chronic liver failure during severe acute exacerbation of chronic hepatitis B virus infection

Yuan¹,

Zeng²,

Liu³

et al. 2019

WJG

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Tenofovir Versus Entecavir for the Treatment of Acute-on-Chronic Liver Failure due to Reactivation of Chronic Hepatitis B With Genotypes B and C

Wan

et al. 2019

Journal of Clinical Gastroenterology

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The Ultra-Short Virological Dynamics in Response to Entecavir or Lamivudine during Chronic Hepatitis B with Spontaneous Severe Acute Exacerbation

Abstract: CHB with spontaneous SAE responded similarly to treatment using either LVD or ETV, with both drugs inducing a rapid decline of HBV viral load.

Cited by 2 publications

References 34 publications

Risk factors for progression to acute-on-chronic liver failure during severe acute exacerbation of chronic hepatitis B virus infection

Risk factors for progression to acute-on-chronic liver failure during severe acute exacerbation of chronic hepatitis B virus infection

Tenofovir Versus Entecavir for the Treatment of Acute-on-Chronic Liver Failure due to Reactivation of Chronic Hepatitis B With Genotypes B and C

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