Lamivudine treatment is associated with improved survival in fulminant hepatitis B

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02450.x/abstract

Lamivudine treatment is associated with improved survival in fulminant hepatitis

B

Jian-Wu Yu, Li-Jie Sun, Bing-Zhu Yan, Peng Kang, Yong-Hua Zhao

Article first published online: 30 JAN 2011

DOI: 10.1111/j.1478-3231.2011.02450.x

© 2011 Wiley & Sons A/S

Issue

Liver International

Volume 31, Issue 4, pages 499-506, April 2011

Abstract

Objective: Fulminant hepatitis B is a clinical syndrome that results from

massive necrosis of liver cells leading to the development of hepatic

encephalopathy. The aim of this study was to evaluate the efficacy of lamivudine

in patients with fulminant hepatitis B and study the prognostic factors.

Methods: A matched retrospective cohort study using data on fulminant hepatitis

B patients derived from our hospital database was conducted. Forty patients

receiving lamivudine treatment were selected into the lamivudine treatment group

with another 40 without lamivudine treatment studied as control. They were

matched for sex, age and HBeAg status with lamivudine treatment group. The

mortality of patients in two groups was compared. The influential factors on the

mortality were studied by proportional hazards model.

Results: The mortality of patients in the lamivudine group (n=38) was

significantly lower than that of the control group (n=39) (63.2 vs. 84.6%;

÷2=4.609, P=0.032). For patients without systemic inflammatory response syndrome

(SIRS), the mortality of patients in the lamivudine group (n=25) was

significantly lower than that of the control group (n=26) (52.0 vs. 80.8%;

÷2=4.747, P=0.029). In multivariate proportional hazards analyses, for

patients without SIRS, age (P=0.037), ratio of total to direct bilirubin

(P=0.008), treatment method (P=0.005) and the decline of hepatitis B virus (HBV)

DNA load during therapy (P=0.019) were independent predictors of prognosis.

Conclusions: Treatment with lamivudine significantly decreases the mortality of

fulminant hepatitis B patients without SIRS, and a rapid decline of HBV DNA load

is one of the good predictors for the treatment outcome.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02450.x/abstract

Lamivudine treatment is associated with improved survival in fulminant hepatitis

B

Jian-Wu Yu, Li-Jie Sun, Bing-Zhu Yan, Peng Kang, Yong-Hua Zhao

Article first published online: 30 JAN 2011

DOI: 10.1111/j.1478-3231.2011.02450.x

© 2011 Wiley & Sons A/S

Issue

Liver International

Volume 31, Issue 4, pages 499-506, April 2011

Abstract

Objective: Fulminant hepatitis B is a clinical syndrome that results from

massive necrosis of liver cells leading to the development of hepatic

encephalopathy. The aim of this study was to evaluate the efficacy of lamivudine

in patients with fulminant hepatitis B and study the prognostic factors.

Methods: A matched retrospective cohort study using data on fulminant hepatitis

B patients derived from our hospital database was conducted. Forty patients

receiving lamivudine treatment were selected into the lamivudine treatment group

with another 40 without lamivudine treatment studied as control. They were

matched for sex, age and HBeAg status with lamivudine treatment group. The

mortality of patients in two groups was compared. The influential factors on the

mortality were studied by proportional hazards model.

Results: The mortality of patients in the lamivudine group (n=38) was

significantly lower than that of the control group (n=39) (63.2 vs. 84.6%;

÷2=4.609, P=0.032). For patients without systemic inflammatory response syndrome

(SIRS), the mortality of patients in the lamivudine group (n=25) was

significantly lower than that of the control group (n=26) (52.0 vs. 80.8%;

÷2=4.747, P=0.029). In multivariate proportional hazards analyses, for

patients without SIRS, age (P=0.037), ratio of total to direct bilirubin

(P=0.008), treatment method (P=0.005) and the decline of hepatitis B virus (HBV)

DNA load during therapy (P=0.019) were independent predictors of prognosis.

Conclusions: Treatment with lamivudine significantly decreases the mortality of

fulminant hepatitis B patients without SIRS, and a rapid decline of HBV DNA load

is one of the good predictors for the treatment outcome.