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The study of efficacy of lamivudine in patients with severe acute hepatitis B.
- Source :
- Digestive Diseases & Sciences; Mar2010, Vol. 55 Issue 3, p775-783, 9p, 4 Charts, 5 Graphs
- Publication Year :
- 2010
-
Abstract
- <bold>Background and Aim: </bold>Severe acute hepatitis B is a rapid deterioration of liver function, which carries a high mortality rate. The aim of this study is to evaluate the efficacy of lamivudine in patients with severe acute hepatitis B.<bold>Methods: </bold>In this study, 80 patients with severe acute hepatitis B were randomly divided into lamivudine and the control group. For the two groups, we compared HBsAg, HBeAg seroconversion rates, serum HBV DNA-negative rate, biochemical indicators, the incidence of liver failure, and mortality. The influential factors on the mortality were studied by Cox proportional hazards model.<bold>Results: </bold>The improvement in serum TBiL, INR, and HBV DNA levels of the lamivudine group was significantly greater than that of the control group. The mortality of lamivudine group (7.5%, 3/40) was significantly lower than that of the control group (25.0%, 10/40) (p = 0.034). The incidence of liver failure (8.7%, 2/23) of patients receiving lamivudine within a week was significantly lower than that (35.3%, 6/17) of those who received it after a week (p = 0.038). In multivariate Cox proportional hazards analyses, age (p = 0.043), ratio of total to direct bilirubin (p = 0.009), treatment method (p = 0.006), and the decline of HBV DNA load during therapy (p = 0.017) were independent predictors of mortality. The HBsAg seroconversion rates (62.5%, 25/40) and HBeAg seroconversion rates (63.6%, 21/33) of the lamivudine group were significantly lower than those (85.0%, 34/40), (87.5%, 28/32) of the control group (p = 0.022, 0.026).<bold>Conclusions: </bold>Early treatment with lamivudine leads to a greater decrease in HBV DNA level, better clinical improvement and mortality improvement in patients with severe acute hepatitis B, but with a lower seroconversion rate. A rapid decline of HBV DNA load is a good predictor for the treatment outcome. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEPATITIS B treatment
VIRAL hepatitis
LIVER diseases
PATIENTS
LAMIVUDINE
ANTI-HIV agents
BILIRUBIN
COMPARATIVE studies
DNA
HEPATITIS B
HEPATITIS viruses
LIVER failure
RESEARCH methodology
MEDICAL cooperation
RESEARCH
STATISTICAL sampling
VIRAL antigens
EVALUATION research
RANDOMIZED controlled trials
PROPORTIONAL hazards models
ACUTE diseases
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 01632116
- Volume :
- 55
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Digestive Diseases & Sciences
- Publication Type :
- Academic Journal
- Accession number :
- 48111263
- Full Text :
- https://doi.org/10.1007/s10620-009-1060-5