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Successful results of early nucleos(t)ide analogue treatment for liver transplantation candidates with severe acute hepatitis B infection.
- Source :
-
European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2024 Jan 01; Vol. 36 (1), pp. 97-100. - Publication Year :
- 2024
-
Abstract
- Background: Early treatment of severe acute hepatitis B virus (HBV) infection with nucleos(t)ide analogues may prevent progression to acute liver failure (ALF).<br />Patients and Methods: The charts of 24 patients who were treated for severe acute HBV infection (either INR ≥ 1.5 or INR≥ 1.4 and total bilirubin ≥ 20 mg/dL at the referring institution or after admission) between April 2021 and May 2023 (inclusive) were evaluated retrospectively. Twelve patients were women; median [range] age: 48 [35-68]. Entecavir (0.5 mg/day) (n = 16) or tenofovir disoproxil fumarate (245 mg/day) (n =8) were used depending on availability.<br />Results: Two patients required liver transplant which was performed successfully in one (no suitable donor for the other). Deterioration to ALF was prevented in 22 of the 24 cases (92%); these patients could be discharged after median (range) 12 (5-24) days following initiation of the antiviral drug. There was no significant difference in efficacy between the two antiviral agents. The anti-HBsAg antibody became positive in 16 patients (73%); one other patient became HBsAg negative at 1 month after discharge but was lost to follow up. Five patients (23%) are still HBsAg positive but all except one have started treatment in the last 6 months. One of the recently treated 4 patients stopped taking the antiviral drug at his own will and one has become anti-HIV antibody positive during follow up.<br />Conclusion: Early treatment of severe acute HBV infection with entecavir or tenofovir disoproxil fumarate prevents the need for liver transplant and consideration of living donors.<br /> (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Humans
Female
Middle Aged
Male
Hepatitis B Surface Antigens
Retrospective Studies
Antiviral Agents adverse effects
Tenofovir therapeutic use
Hepatitis B virus
Treatment Outcome
Liver Transplantation adverse effects
Hepatitis B complications
Hepatitis B diagnosis
Hepatitis B drug therapy
Liver Failure, Acute diagnosis
Liver Failure, Acute drug therapy
Liver Failure, Acute surgery
Hepatitis B, Chronic complications
Hepatitis B, Chronic diagnosis
Hepatitis B, Chronic drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5687
- Volume :
- 36
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of gastroenterology & hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 37823433
- Full Text :
- https://doi.org/10.1097/MEG.0000000000002655