Antonija Verhaz*
Volume5-Issue6
Dates: Received: 2024-06-19 | Accepted: 2024-06-28 | Published: 2024-06-28
Pages: 670-674
Abstract
Objectives: Lamivudin has been approved for the treatment of chronic hepatitis B but experience with lamivudin treatment for acute severe hepatitis B is still limited. Fulminant hepatitis develops in 1% of patients with acute hepatitis B. Severe acute hepatitis B in immunocompetent patients may progress to fulminant hepatitis and death.
Aim: To evaluate the efficasy of lamivudine for the treatment of acute severe hepatitis B virus infection in imunocompetent adults in Clinic for infectious diseases Banja Luka.
Patients and methods: In the period of 2006-2024 years, 12 immunocompetent patients (4 women, 8 men, age 24-77 years) with severe acute hepatitis B were treated with lamivudin. All 12 patients fulfil at least two of the criteria for severe acute hepatitis B infection: 1. hepatic encephalopathy; 2. total bilirubin 210 micromole per litre; and severe coagulopathy (international normalized ratio-INR was 4.5 ± 6.4 or prothrombin time-PT < 40%). All patients had evidence of severe hepatocyte lysis. Nine patients had rapid increase of total bilirubin and contemporary decrease of alanine aminotransferase level, which escalate risk of development of fulminant hepatitis B.
All patients received lamivudin at a dose 100 mg per day.
Results: Ten patients responded well to the treatment and their biochemical parameters improved rapidly. Within 1-6 months, the HBsAg was undetectable in 10 out of 12 investigated patients. Protective anti-HBs antibodies developed in 10 of them in 1-6 months. The corticosteroid therapy was short-term in 2 of 12 patients. Two patient developed fulminant hepatitis B and died after the lamivudine therapy was initiated. Lamivudine treatment was well tolerated in all patients.
Conclusion: Lamivudin induces a prompt clinical, biochemical and serological response in immunocompetent patients with severe acute hepatitis B. Early treatment with lamivudine probably decreases the risk of progression to fulminant hepatitis in patients with severe acute hepatitis B.
FullText HTML
FullText PDF
DOI: 10.37871/jbres1941
Certificate of Publication
Copyright
© 2024 Verhaz A. Distributed under Creative Commons CC-BY 4.0 
How to cite this article
Verhaz A. The Study of Effi cacy and Safe of Lamivudine in Patients with Severe Acute Hepatitis B. J Biomed Res Environ Sci. 2024 Jun 28; 5(6): 670-674. doi: 10.37871/jbres1941, Article ID: JBRES1941, Available at: https://www.jelsciences.com/ articles/jbres1941.pdf
Subject area(s)
References
- Schmilovitz-Weiss H, Ben-Ari Z, Sikuler E, Zuckerman E, Sbeit W, Ackerman Z, Safadi R, Lurie Y, Rosner G, Tur-Kaspa R, Reshef R. Lamivudine treatment for acute severe hepatitis B: a pilot study. Liver Int. 2004 Dec;24(6):547-51. doi: 10.1111/j.1478-3231.2004.0983.x. Erratum in: Liver Int. 2005 Feb;25(1):196. PMID: 15566503.
- Roussos A, Koilakou S, Kalafatas I, Kalantzis C, Apostolou N, Grivas E, Raptis N, Mantzaris G. Lamivudine treatment for acute severe hepatitis B: report of a case and review of the literature. Acta Gastroenterol Belg. 2008 Jan-Mar;71(1):30-2. PMID: 18396747.
- Reshef R, Kaspa RT. Lamivudine in the treatment of acute hepatitis B. N Engl J Med 2000;343:1123-1124. doi: 10.1056/NEJM200010123431513.
- Roznovský L, Orságová I, Kloudová A, Mrázek J. Lécba lamivudinem u pacientů s tezkou akutní virovou hepatitidou B [Lamivudine therapy in patients with severe acute hepatitis B]. Klin Mikrobiol Infekc Lek. 2007 Apr;13(2):59-65. Czech. PMID: 17599294.
- Kumar M, Satapathy S, Monga R, Das K, Hissar S, Pande C, Sharma BC, Sarin SK. A randomized controlled trial of lamivudine to treat acute hepatitis B. Hepatology. 2007 Jan;45(1):97-101. doi: 10.1002/hep.21486. PMID: 17187417.
- European Medicines Agency's.
- Kondili LA, Osman H, Mutimer D. The use of lamivudine for patients with acute hepatitis B (a series of cases). J Viral Hepat. 2004 Sep;11(5):427-31. doi: 10.1111/j.1365-2893.2004.00504.x. PMID: 15357647.
- Tillmann HL, Hadem J, Leifeld L, Zachou K, Canbay A, Eisenbach C, Graziadei I, Encke J, Schmidt H, Vogel W, Schneider A, Spengler U, Gerken G, Dalekos GN, Wedemeyer H, Manns MP. Safety and efficacy of lamivudine in patients with severe acute or fulminant hepatitis B, a multicenter experience. J Viral Hepat. 2006 Apr;13(4):256-63. doi: 10.1111/j.1365-2893.2005.00695.x. PMID: 16611192.
- Torii N, Hasegawa K, Ogawa M, Hashimo E, Hayashi N. Effectiveness and long-term outcome of lamivudine therapy for acute hepatitis B. Hepatol Res. 2002 Sep;24(1):34. doi: 10.1016/s1386-6346(02)00009-8. PMID: 12243790.
- Streinu-Cercel A, Sandulescu O, Stefan M, Streinu-Cercel A. Treatment with lamivudine and entecavir in severe acute hepatitis B. Indian J Med Microbiol. 2016 Apr-Jun;34(2):166-72. doi: 10.4103/0255-0857.176837. PMID: 27080767.
- Verhaz A. Experience with lamivudine treatment for severe acute hepatitis B. Srp Arh Celok Lek. 2014 Nov-Dec;142(11-12):703-7. doi: 10.2298/sarh1412703v. PMID: 25731000.
