Abstract:
:The short-term prognosis of patients with severe acute exacerbation of chronic hepatitis B (CHB) leading to acute liver failure is extremely poor. We have reported the efficacy of corticosteroid in combination with nucleoside analogue in the early stages, but virological efficacy has not been documented. Our aim was to elucidate the virological efficacy of this approach. Thirteen patients defined as severe acute exacerbation of CHB by our uniform criteria were prospectively examined for virological responses to treatment. Nucleoside analogue and sufficient dose of corticosteroids were introduced as soon as possible after the diagnosis of severe disease. Of the 13 patients, 7 (54%) survived, 5 (38%) died and 1 (8%) received liver transplantation. The decline of HBV DNA was significant between the first 2 weeks (P = 0.02) and 4 weeks (P < 0.01). Mean reduction in HBV DNA during the first 2 weeks was 1.7 ± 0.9 log copies per mL in overall patients, 2.1 ± 0.8 in survived patients and 1.2 ± 0.9 in dead/transplanted patients. The decline of HBV DNA was significant between the first 2 weeks (P = 0.03) and 4 weeks (P = 0.02) in survived patients, but not in dead/transplanted patients. Our study shows that corticosteroid treatment in combination with nucleotide analogue has sufficient virological effect against severe acute exacerbation of CHB, and a rapid decline of HBV DNA is conspicuous in survived patients.
journal_name
J Viral Hepatjournal_title
Journal of viral hepatitisauthors
Yasui S,Fujiwara K,Nakamura M,Miyamura T,Yonemitsu Y,Mikata R,Arai M,Kanda T,Imazeki F,Oda S,Yokosuka Odoi
10.1111/jvh.12258subject
Has Abstractpub_date
2015-02-01 00:00:00pages
94-102issue
2eissn
1352-0504issn
1365-2893journal_volume
22pub_type
杂志文章abstract::The efficacy and tolerability of 12-month treatment with titrated doses of recombinant interferon-alpha 2a (IFN-alpha 2a) in chronic hepatitis C were studied in 67 consecutively recruited patients randomly assigned either to a starting dose of IFN-alpha 2a 6 MU, subsequently adjusted to the serum alanine aminotransfer...
journal_title:Journal of viral hepatitis
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 临床试验,杂志文章
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更新日期:2007-10-01 00:00:00
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