Treatment of fibrosing cholestatic hepatitis with lamivudine

Chan, Tak‐Mao; Wu, P. C.; Li, Fu-Keung; Lai, Ching–Lung; Cheng, Ignatius K.P.; Lai, Kar‐Neng

doi:10.1016/s0016-5085(98)70380-4

Cited by 78 publications

(52 citation statements)

References 17 publications

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“…Other studies showed that the preferential increase in the number of HBV-specific CD8 T and CD4 T cells is associated with viral control rather than liver damage [38,39]. Whatever the mechanism of AE, a few weeks are needed for sufficient suppression of the production of HBV-related proteins by preventing HBV replication even when NAs are used [40]. Thus, earlier introduction of CS in combination with potent antiviral therapy is a reasonable approach for the initial treatment of AE to prevent excessive immunological reactions and progression of liver cell injury [22,41].…”

Section: Discussionmentioning

confidence: 99%

Determinants of the clinical outcome of patients with severe acute exacerbation of chronic hepatitis B virus infection

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Determinants of the clinical outcome of patients with severe acute exacerbation of chronic hepatitis B virus infection

et al. 2012

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“…Early treatment seems advisable, because lifethreatening complications may not be averted by treatment that is started after the development of severe liver disease. 18,36 Therefore, it has been common practice to start lamivudine prophylactically at the time of transplantation. This approach is not unreasonable in view of the difficulty in predicting the timing of exacerbations and may be necessary when facilities or resources for HBV DNA assay are not available.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15][16] We and others have reported favorable results with lamivudine in the treatment of fibrosing cholestatic hepatitis B, which hitherto has been associated with nearly uniform mortality. 17,18 However, many critical issues remain unresolved. It is not known whether patient survival can be Abbreviations: HBV, hepatitis B virus; HBsAg, hepatitis B surface antigen; ALT, alanine aminotransferase; HBeAg, hepatitis B e antigen.…”

Section: H Epatitis B Virus (Hbv) Infection Is An Importantmentioning

confidence: 99%

Preemptive lamivudine therapy based on HBV DNA level in HBsAg-positive kidney allograft recipients

et al. 2002

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Hepatitis B surface antigen (HBsAg)-positive kidney transplant recipients have increased liver-related mortality. The impact of lamivudine treatment on patient survival, the optimal time to start treatment, and the feasibility of discontinuing treatment have not been determined. This study examined these issues with a novel management protocol. Serum hepatitis B virus (HBV) DNA levels were measured serially in HBsAg-positive kidney transplant recipients, and lamivudine was administered preemptively to patients with increasing HBV DNA levels with or without elevation of aminotransferase levels. Outcomes of patients who underwent transplantation before or after institution of this preemptive management strategy (in January 1996) were compared. H epatitis B virus (HBV) infection is an importantcause of morbidity and mortality after kidney transplantation. [1][2][3][4][5] The number of chronic HBV carriers exceeds 300 million worldwide, and up to 14% of renal allograft recipients in endemic areas are hepatitis B surface antigen (HBsAg) positive. 6,7 Progressive liver disease affects more than 80% of HBsAg-positive renal transplant recipients 8,9 and accounts for 37% to 57% of mortality. 3,4,9 Life-threatening exacerbation of liver disease can develop in previously healthy HBV carriers. An optimal monitoring and treatment regimen for HBsAg-positive renal allograft recipients has not been defined.Lamivudine is a nucleoside analogue with proven efficacy in suppressing HBV DNA levels and ameliorating aminotransferase and histologic abnormalities in nonimmunosuppressed patients with chronic hepatitis B. 10,11 Short-term studies have shown virologic and biochemical efficacy in small series of renal transplant recipients. [12][13][14][15][16] We and others have reported favorable results with lamivudine in the treatment of fibrosing cholestatic hepatitis B, which hitherto has been associated with nearly uniform mortality. 17,18 However, many critical issues remain unresolved. It is not known whether patient survival can be Abbreviations: HBV, hepatitis B virus; HBsAg, hepatitis B surface antigen; ALT, alanine aminotransferase; HBeAg, hepatitis B e antigen.

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“…Lamivudine has been shown to reverse FCH in a renal transplant patient who developed acute de novo hepatitis B 8 mo after the renal transplant (Chan et al 1998).…”

Section: Patients Receiving Transplantationmentioning

confidence: 99%