Entecavir and lamivudine therapy for severe acute chronic hepatitis B

Liu,Changhong; Ye,Jing; Jia,Hongyu; Zhang,Meijuan; Han,Hongfeng; Chen,Fengzhe; Chen,Congkang

doi:10.3892/etm.2012.850

Entecavir and lamivudine therapy for severe acute chronic hepatitis B

Authors:
- Changhong Liu
- Jing Ye
- Hongyu Jia
- Meijuan Zhang
- Hongfeng Han
- Fengzhe Chen
- Congkang Chen
View Affiliations

Affiliations: Department of Gastroenterology, Shandong Provincial Qianfoshan Hospital, Zhejiang University, Zhejiang, P.R. China, Department of Infectious Diseases, Lishui Central Hospital, Zhejiang University, Zhejiang, P.R. China, Department of Infectious Diseases, The First Affiliated Hospital of the College of Medicine, Zhejiang University, Zhejiang, P.R. China, Department of Gastroenterology, Luoyang Central Hospital, Henan, P.R. China, Department of Infectious Diseases, Qilu Hospital of Shandong University, Jinan, P.R. China, Department of Internal Medicine, Beilun District Hospital of Chinese Medicine, Ningbo, P.R. China
Published online on: December 5, 2012 https://doi.org/10.3892/etm.2012.850
Pages: 545-548

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Severe acute exacerbation in patients with chronic hepatitis B is a unique clinical presentation that results in high mortality. To compare the efficacy of 4 weeks of entecavir or lamivudine therapy in patients with severe acute exacerbation caused by chronic hepatitis B, 65 patients were retrospectively analyzed. The groups received 0.5 mg entecavir (group A) or 100 mg lamivudine (group B) daily. After 4 weeks of treatment, virological and biochemical responses and the deterioration rates were determined. The average age and alanine aminotransferase (ALT), bilirubin, albumin, creatinine (Cr), and HBV DNA levels were similar in groups A and B prior to treatment, but the prothrombin time (PT) was shorter in group A. Following treatment, ALT and bilirubin levels were improved while there were no significant changes in PT, albumin or Cr levels at week 4 in group B. Only ALT was markedly upregulated following treatment in group A. There were no significant differences between the virological and biochemical responses or the deterioration rates of the two groups. These results suggested that short‑term treatment with lamivudine markedly alleviated the increased bilirubin (TB) levels in patients with severe acute exacerbation of chronic hepatitis B and that there was no significant difference in the deterioration rate between patients treated by the two types of medication.

View Figures

View References

1.	Lee WM: Hepatitis B virus infection. N Engl J Med. 337:1733–1745. 1997. View Article : Google Scholar : PubMed/NCBI
2.	Wong VW and Chan HL: Severe acute exacerbation of chronic hepatitis B: a unique presentation of a common disease. J Gastroenterol Hepatol. 24:1179–1186. 2009. View Article : Google Scholar : PubMed/NCBI
3.	Liaw YF, Leung N, Kao JH, et al Chronic Hepatitis B Guideline Working Party of the Asian-Pacific Association for the study of the Liver: Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2008 update. Hepatol Int. 2:263–283. 2008. View Article : Google Scholar : PubMed/NCBI
4.	Liaw YF, Sung JJ, Chow WC, et al Cirrhosis Asian Lamivudine Multicentre Study Group: Lamivudine for patients with chronic hepatitic B and advanced liver disease. N Engl J Med. 351:1521–1531. 2004. View Article : Google Scholar : PubMed/NCBI
5.	Chan HL, Wong VW, Hui AY, et al: Long-term lamivudine treatment is associated with a good maintained response in severe acute exacerbation of chronic HBeAg-negative hepatitis B. Antivir Ther. 11:465–471. 2006.PubMed/NCBI
6.	Wong VW, Wong GL, Tsang SW, et al: Long-term follow-up of lamivudine treatment in patients with severe acute exacerbation of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. Antivir Ther. 13:571–579. 2008.PubMed/NCBI
7.	Tsubota A, Arase Y, Suzuki Y, et al: Benefit of lamivudine therapy and factors associated with clinical outcome in spontaneous severe acute exacerbation of chronic hepatitis B virus infection. Intervirology. 47:335–341. 2004. View Article : Google Scholar
8.	Ghany MG and Doo EC: Antiviral resistance and hepatitis B therapy. Hepatology. 49(Suppl 5): S174–S184. 2009. View Article : Google Scholar : PubMed/NCBI
9.	Tenney DJ, Rose RE, Baldick CJ, et al: Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naïve patients is rare through 5 years of therapy. Hepatology. 49:1503–1514. 2009.PubMed/NCBI
10.	Yao G: Entecavir is a potent anti-HBV drug superior to lamivudine: experience from clinical trials in China. J Antimicrob Chemother. 60:201–205. 2007. View Article : Google Scholar : PubMed/NCBI
11.	Colonno RJ, Rose R, Baldick CJ, et al: Entecavir resistance is rare in nucleoside naïve patients with hepatitis B. Hepatology. 44:1656–1665. 2006.
12.	Wong VW, Wong GL, Yiu KK, et al: Entecavir treatment in patients with severe acute exacerbation of chronic hepatitis B. J Hepatol. 54:236–242. 2011. View Article : Google Scholar : PubMed/NCBI
13.	Tsang SW, Chan HL, Leung NW, Chau TN, Lai ST, Chan FK and Sung JJ: Lamivudine treatment for fulminant hepatic failure due to acute exacerbation of chronic hepatitis B infection. Aliment Pharmacol Ther. 15:1737–1744. 2001. View Article : Google Scholar : PubMed/NCBI
14.	Sarin SK, Kumar A, Almeida JA, et al: Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL). Hepatol Int. 3:269–282. 2009. View Article : Google Scholar
15.	Chan HL, Tsang SW, Hui Y, Leung NW, Chan FK and Sung JJ: The role of lamivudine and predictors of mortality in severe flare-up of chronic hepatitis B with jaundice. J Viral Hepat. 9:424–428. 2002. View Article : Google Scholar : PubMed/NCBI
16.	Tsubota A, Arase Y, Suzuki Y, et al: Lamivudine monotherapy for spontaneous severe acute exacerbation of chronic hepatitis B. J Gastroenterol Hepatol. 20:426–432. 2005. View Article : Google Scholar : PubMed/NCBI
17.	Chien RN, Lin CH and Liaw YF: The effect of lamivudine therapy in hepatic decompensation during acute exacerbation of chronic hepatitis B. J Hepatol. 38:322–327. 2003. View Article : Google Scholar : PubMed/NCBI
18.	Thabut D, Ratziu V, Bernard-Chabert B, Poynard T, Benhamou Y and Thibault V: Unsuccessful rescue therapy with adefovir dipivoxil for lamivudine resistant HBV in a patient with liver failure. Gut. 52:6142003. View Article : Google Scholar : PubMed/NCBI
19.	Wiegand J, Tischendorf JJ, Nashan B, et al: Severe exacerbation of chronic hepatitis B after emergence of lamivudine resistance in a cirrhotic patient: immediate switch to adefovir dipivoxil appears to be indicated. Z Gastroenterol. 42:15–18. 2004. View Article : Google Scholar