EARLY LAMIVUDINE THERAPY MAY PREVENT LIVER FAILURE IN PATIENTS WITH FULMINANT HEPATITIS B
-Abstract 848
Hans L Tillmann, Heiner Wedemeyer, Johannes Hadem, Thomas Rudolph,
Anasthasia Dick, Ingolf Schedel, Andrea Schneider, Christian Trautwein,
Michael P Mantis, Dept. of Gastroenterology, Hepatology and ndocrinology, Hannover Medical School, Hannover, Germany
Lamivudine is an oral nucleoside analogue inhibiting hepatitis B viral
replication with an adverse event rate similar to placebo. It was recently
licensed for the treatment of chronic hepatitis B. Fulminant hepatitis is a
deleterious form of acute hepatitis B virus infection occurring in about 1%
of cases eventually leading to liver failure and the need of liver
transplantation in most patients.
A total of 29 patients had been transferred to our unit for treatment of
fulminant hepatitis B between 1993 and March 2002. From September 2000 on, we initiated lamivudine treatment in patients with acute hepatitis B once we had evidence for a fulminant course. No lamivudine was administered in 21 patients while B patients received lamivudine 150mg daily after the diagnosis of fulminant hepatitis B was made.
The results of this study showed that baseline characteristics for both
groups were similar. Lamivudine treated patients had a shorter ICU stay
than untreated patients (5.4?5.9 days vs. 21.2?8.8 days; p=0.023) Only one of the eight patients treated with lamivudine, but 16 of 21 (76.2%) patients who did not receive lanuivudine required liver transplantation or died (p=0.003) All patients except two treated with lamivudine recovered quickly without adverse events. The only patient requiring transplantation despite lamivudine therapy also had ingested paracetamol, and was also the most advanced patient.
In summary, Lamivudine is safe in patients with fulminant hepatitis B,
leading to fast recovery with the potential to prevent liver failure when
administered early enough.
[此贴子已经被作者于2002-11-8 9:20:20编辑过]
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发表于 2002-11-8 23:20
