Literature DB >> 18628576

Lamivudine treatment improves the prognosis of fulminant hepatitis B.

Yasuhiro Miyake1, Yoshiaki Iwasaki, Akinobu Takaki, Shin-ichi Fujioka, Kouichi Takaguchi, Hiroshi Ikeda, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori.   

Abstract

OBJECTIVE: The efficacy of lamivudine for fulminant hepatitis B has been reported in Europe and West Asia. However, in these reports, the main infection genotype is D. Furthermore, if lamivudine improves survival, prognostic factors for fulminant hepatitis B may differ from those reported previously. The aim of this study was to clarify the prognostic factors and the efficacy of lamivudine for fulminant hepatitis B in Japan, where the main infection genotype is B.
METHODS: This study was a retrospective cohort study. We selected 37 consecutive patients with fulminant hepatitis due to acute hepatitis B virus infection. As 4 of them had received liver transplantation, the data of 33 patients with a median age of 45 (range, 20-74) years were analyzed.
RESULTS: Lamivudine was administered to 10 patients. There were no differences in clinical features at the time of the diagnosis of fulminant hepatitis B between patients treated with and without lamivudine. Survival rates of patients treated with and without lamivudine were 70% and 26%, respectively. Age (> or =45 years), systemic inflammatory response syndrome, and non-administration of lamivudine were associated with fatal outcomes. The survival rates of patients treated with and without lamivudine, who were in a state of systemic inflammatory response syndrome, were 50% and 9%, and in patients aged > or =45 years, 50% and 8%, respectively.
CONCLUSION: This study suggests the efficacy of lamivudine for fulminant hepatitis B in the area where the main infection genotype is B. We consider that lamivudine is worth administering to patients with fulminant hepatitis B.

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Year:  2008        PMID: 18628576     DOI: 10.2169/internalmedicine.47.1061

Source DB:  PubMed          Journal:  Intern Med        ISSN: 0918-2918            Impact factor:   1.271


  14 in total

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