Lamivudine treatment for severe acute HBV hepatitis

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Int J Med Sci. 2008;5(6):309-12. Epub 2008 Oct 23.

Lamivudine treatment for severe acute HBV hepatitis.

Lisotti A, Azzaroli F, Buonfiglioli F, Montagnani M, Alessandrelli F, Mazzella

G.

Department of Digestive Disease and Internal Medicine, University Alma Mater

Studiorum of Bologna, Ospedale S'Orsola-Malpighi via Massarenti 9 Bologna,

Italy.

Treatment for acute hepatitis B is recommended in order to reduce the risk of

progression to fulminant hepatitis and the need of OLT. We report our experience

on treatment with high dose lamivudine, in patients with severe acute HBV

infection. The diagnosis was based on clinical and virological findings and

exclusion of other known causes of liver damage. The decision to treat was based

on the prolongation of INR together with increasing values of bilirubin and ALT.

Four patients received Lamivudine 200 mg/daily until clearance of serum HBV-DNA

and then 100 mg/daily until clearance of HBsAg and appearance of anti-HBs

antibodies. One patient received 100 mg/daily because of chronic renal

impairment. The median period of hospitalization was 13 days, and none of the

patients had complications, related either to underlying disease or to therapy.

The complete normalization of serum transaminases and bilirubin occurred on

average after 5.5 weeks and 3 weeks respectively. All patients cleared serum

HBV-DNA within three months, lost HBeAg and HBsAg and seroconverted to anti-HBe;

four patients developed anti-HBs at a protective titre. Early antiviral

treatment attenuates the clinical and biochemical impairment leading to fast

healing and promoting complete recovery.

PMID: 18974858 [PubMed - in process]