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发表于 2003-1-25 22:39
Early Epivir-HBV (lamivudine) Therapy May Prevent Liver Failure in Patients with Fulminant Hepatitis B
Epivir-HBV (lamivudine; 3TC) is an oral nucleoside analogue inhibiting hepatitis B viral replication with an adverse event rate similar to placebo. Epivir-HBV is one of three agents (Intron A and Hepsera are the other two) that is FDA-approved for the treatment of chronic hepatitis B in the US. Epivir is also FDA-approved for the treatment of HIV infection.
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.
Researchers conducted the present study at the Hanover Medical School in Hanover, Germany. A total of 29 patients had been transferred to the Department of gastroenterology for treatment of fulminant hepatitis B between 1993 and March 2002.
From September 2000 on, the investigators initiated Epivir-HBV treatment in patients with acute hepatitis B once they had evidence for a fulminant course. No Epivir-HBV was administered in 21 patients and 8 patients received Epivir-HBV 150mg daily after the diagnosis of fulminant hepatitis B was made.
Baseline characteristics for both groups were similar. Epivir-HBV treated patients had a shorter ICU stay than untreated patients (5.4-5.9 days vs. 21.2-28.8 days; p=0.023).
Only one of the eight patients treated using Epivir-HBV, but 16 of 21 (76.2%) patients who did not receive Epivir-HBV required liver transplantation or died (p=0.003). All patients except two treated with Epivir-HBV recovered quickly without adverse events.
The only patient requiring transplantation despite Epivir-HBV therapy also had ingested paracetamol, and was also the most advanced patient.
Conclusion: When administered early enough, Epivir-HBV is safe in patients with fulminant hepatitis B, leading to quick recovery and with the potential to prevent liver failure.
01/22/03
Reference
H L Tillmann and others. EARLY LAMIVUDINE THERAPY MAY PREVENT LIVER FAILURE IN PATIENTS WITH FULMINANT HEPATITIS B. Abstract 848. 53rd AASLD. November 1-5, 2002. Boston, MA. Hepatology 2002: Vol 36 No 4, Pt 2 of 2.
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