A team from Hong Kong, China, evaluated the efficacy of lamivudine in the treatment of fulminant hepatic failure due to acute exacerbation of chronic hepatitis B infection.
A total of 24 patients with this condition were included in the study. Each was treated with lamivudine, 100 mg daily.
Hepatitis A, C, D and human immunodeficiency virus co-infections, and hepatocellular carcinoma were excluded.
The median age of the patients was 53 years, with a male predominance of 5:1.
Some 17 patients were hepatitis B e antigen-positive. The mean hepatitis B virus DNA was found to be 2079 Meq/ml.
|Outcomes for lamivudine-treated subjects:|
Liver transplanted: 13%
| Alimentary Pharmacology & Therapeutics |
Of the individuals treated, 8 (33%) survived (Group A); 13 patients died; and 3 patients received liver transplantation (67%) (Group B).
Baseline laboratory results were comparable between the two groups, including serum albumin, bilirubin, alanine aminotransferase, prothrombin time, and creatinine.
The researchers found that Group B patients had significantly more comorbid illnesses at baseline, and more complications, including sepsis and renal failure, compared with Group A patients.
Of the 8 survivors, 6 (75%) had full hepatitis B e antigen seroconversion. However, this was not sustained in 4 patients.
Dr S. W. C. Tsang, of the Prince of Wales Hospital, New Territories, Hong Kong, said on behalf of fellow authors, "Lamivudine may be useful in treating patients with fulminant hepatic failure due to exacerbation of chronic hepatitis B."
"Hepatitis B e antigen seroconversion was less durable in this subgroup of patients and long-term therapy may be required," it was concluded.