tailieunhanh - Báo cáo y học: "Lamivudine treatment for severe acute HBV hepatitis"

Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: Lamivudine treatment for severe acute HBV hepatitis. | Int. J. Med. Sci. 2008 5 309 International Journal of Medical Sciences ISSN 1449-1907 2008 5 6 309-312 Ivyspring International Publisher. All rights reserved Research Paper Lamivudine treatment for severe acute HBV hepatitis Andrea Lisotti Francesco Azzaroli Federica Buonfiglioli Marco Montagnani Flavio Alessandrelli Giuseppe Mazzella H Department of Digestive Disease and Internal Medicine University Alma Mater Studiorum of Bologna Ospedale S Orsola-Malpighi via Massarenti 9 Bologna Italy H Correspondence to Prof. Giuseppe Mazzella phone fax 0039516364120 email Received Accepted Published Treatment for acute hepatitis B is recommended in order to reduce the risk of progression to fulminant hepatitis and the need of OLT. We report our experience on treatment with high dose lamivudine in patients with severe acute HBV infection. The diagnosis was based on clinical and virological findings and exclusion of other known causes of liver damage. The decision to treat was based on the prolongation of INR together with increasing values of bilirubin and ALT. Four patients received Lamivudine 200 mg daily until clearance of serum HBV-DNA and then 100 mg daily until clearance of HBsAg and appearance of anti-HBs antibodies. One patient received 100 mg daily because of chronic renal impairment. The median period of hospitalization was 13 days and none of the patients had complications related either to underlying disease or to therapy. The complete normalization of serum transaminases and bilirubin occurred on average after weeks and 3 weeks respectively. All patients cleared serum HBV-DNA within three months lost HBeAg and HBsAg and seroconverted to anti-HBe four patients developed anti-HBs at a protective titre. Early antiviral treatment attenuates the clinical and biochemical impairment leading to fast healing and promoting complete recovery. Key words acute HBV hepatitis lamivudine fulminant .