Lamivudine treatment improves the prognosis of fulminant hepatitis B

Yasuhiro Miyake, Yoshiaki Iwasaki, Akinobu Takaki, Shin Ichi Fujioka, Kouichi Takaguchi, Hiroshi Ikeda, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Objective: The efficacy of lamivudine for fulminant hepatitis B has been reported in Europe and West Asia. However, in these reports, the main infection genotype is D. Furthermore, if lamivudine improves survival, prognostic factors fof fulminant hepatitis B may differ from those reported previously. The aim of this study was to clarify the prognostic factors and the efficacy of lamivudine for fulminant hepatitis B in Japan, where the main infection genotype is B. Methods: This study was a retrospective cohort study. We selected 37 consecutive patients with falminant hepatitis due to acute hepatitis B virus infection. As 4 of them had received liver transplantation, the data of 33 patients with a median age of 45 (range, 20-74) years were analyzed. Results: Lamivudine was administered to 10 patients. There were no differences in clinical features at the time of the diagnosis of fulminant hepatitis B between patients treated with and without lamivudine. Survival rates of patients treated with and without lamivudine were 70% and 26%, respectively. Age (≥45 years), systemic inflammatory response syndrome, and non-admimistration of lamivudine were associated with fatal outcomes. The survival rates of patients treated with and without lamivudine, who were in a state of systemic inflammatory response syndrome, were 50% and 9%, and in patients aged ≥45 years, 50% and 8%, respectively. Conclusion: This study suggests the efficacy of lamivudine for fulminant hepatitis B in the area where the main infection genotype is B. We consider that lamivudine is worth administering to patients with fulminant hepatitis B.

Original languageEnglish
Pages (from-to)1293-1299
Number of pages7
JournalInternal Medicine
Volume47
Issue number14
DOIs
Publication statusPublished - 2008

Fingerprint

Lamivudine
Hepatitis B
Therapeutics
Systemic Inflammatory Response Syndrome
Genotype
Survival Rate
Infection
Fatal Outcome
Virus Diseases
Hepatitis B virus
Liver Transplantation
Hepatitis
Japan
Cohort Studies
Retrospective Studies

Keywords

  • Fulminant hepatitis B
  • Lamivudine
  • Systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

Cite this

Lamivudine treatment improves the prognosis of fulminant hepatitis B. / Miyake, Yasuhiro; Iwasaki, Yoshiaki; Takaki, Akinobu; Fujioka, Shin Ichi; Takaguchi, Kouichi; Ikeda, Hiroshi; Kobashi, Haruhiko; Sakaguchi, Kohsaku; Shiratori, Yasushi.

In: Internal Medicine, Vol. 47, No. 14, 2008, p. 1293-1299.

Research output: Contribution to journalArticle

Miyake, Y, Iwasaki, Y, Takaki, A, Fujioka, SI, Takaguchi, K, Ikeda, H, Kobashi, H, Sakaguchi, K & Shiratori, Y 2008, 'Lamivudine treatment improves the prognosis of fulminant hepatitis B', Internal Medicine, vol. 47, no. 14, pp. 1293-1299. https://doi.org/10.2169/internalmedicine.47.1061
Miyake, Yasuhiro ; Iwasaki, Yoshiaki ; Takaki, Akinobu ; Fujioka, Shin Ichi ; Takaguchi, Kouichi ; Ikeda, Hiroshi ; Kobashi, Haruhiko ; Sakaguchi, Kohsaku ; Shiratori, Yasushi. / Lamivudine treatment improves the prognosis of fulminant hepatitis B. In: Internal Medicine. 2008 ; Vol. 47, No. 14. pp. 1293-1299.
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AB - Objective: The efficacy of lamivudine for fulminant hepatitis B has been reported in Europe and West Asia. However, in these reports, the main infection genotype is D. Furthermore, if lamivudine improves survival, prognostic factors fof fulminant hepatitis B may differ from those reported previously. The aim of this study was to clarify the prognostic factors and the efficacy of lamivudine for fulminant hepatitis B in Japan, where the main infection genotype is B. Methods: This study was a retrospective cohort study. We selected 37 consecutive patients with falminant hepatitis due to acute hepatitis B virus infection. As 4 of them had received liver transplantation, the data of 33 patients with a median age of 45 (range, 20-74) years were analyzed. Results: Lamivudine was administered to 10 patients. There were no differences in clinical features at the time of the diagnosis of fulminant hepatitis B between patients treated with and without lamivudine. Survival rates of patients treated with and without lamivudine were 70% and 26%, respectively. Age (≥45 years), systemic inflammatory response syndrome, and non-admimistration of lamivudine were associated with fatal outcomes. The survival rates of patients treated with and without lamivudine, who were in a state of systemic inflammatory response syndrome, were 50% and 9%, and in patients aged ≥45 years, 50% and 8%, respectively. Conclusion: This study suggests the efficacy of lamivudine for fulminant hepatitis B in the area where the main infection genotype is B. We consider that lamivudine is worth administering to patients with fulminant hepatitis B.

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