The use of lamivudine for patients with acute hepatitis B (a series of cases)
The use of lamivudine for patients with acute hepatitis B (a series of cases)
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DOI：
10.1111/j.1365-2893.2004.00504.x
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发表时间：
2004-09-01
影响因子：
2.5
通讯作者：
Mutimer, D
中科院分区：
文献类型：
--
作者：
Kondili, LA;Osman, H;Mutimer, D
拉米夫定在严重急性乙型肝炎患者中的应用数据有限。我们报告了我们在6例急性乙型肝炎感染患者中使用拉米夫定的经验。4名患者的疾病严重程度和2名患者的慢性风险证明拉米夫定是合理的。治疗患者的诊断为：暴发性肝衰竭（2例），重度急性乙型肝炎，慢性急性乙型肝炎，肾透析环境新发HBV感染（2例，重度肝损伤1例）。拉米夫定开始前，血清HBV DNA滴度范围为10(5)至10(7)拷贝/mL。拉米夫定治疗与所有患者血清HBV DNA和血清转氨酶下降相关。除了一名病人外，其余病人都活了下来。一名患有暴发性肝炎和多器官衰竭的58岁男子在抗病毒治疗后死亡。如果可能，在随访期间记录HBeAg和HBsAg的血清转换。在缺乏拉米夫定在严重急性乙型肝炎患者中的随机前瞻性研究的情况下，我们的数据鼓励使用这种安全且耐受性良好的药物。
There are limited data on the use of lamivudine for patients with severe forms of acute hepatitis B. We report our experience with the use of lamivudine in six patients with acute HBV infection. Lamivudine was justified by disease severity for four patients and by concerns about risk of chronicity for two patients. The diagnoses of the treated patients were: fulminant liver failure (two patients), severe acute hepatitis B, protracted acute hepatitis B, and new HBV infection in the renal dialysis setting (two patients, one with severe liver injury). Serum HBV DNA titres ranged from 10(5) to 10(7) copies/mL prior to commencement of lamivudine. Lamivudine treatment was associated with a decline in serum HBV DNA and serum transaminases in all patients. All but one patient survived. A 58-year-old man with fulminant hepatitis and multiple organ failure died despite antiviral treatment. When possible, HBeAg and HBsAg seroconversion was documented during follow-up. In the absence of a randomized, prospective study of lamivudine in patients with severe acute hepatitis B, our data encourage the use of this safe and well tolerated drug.