Prostaglandin E plus famciclovir--a new concept for the treatment of severe hepatitis B after liver transplantation.
New concepts for the treatment of hepatitis B in immunocompromised patients are urgently needed. We describe our first experience with the new antiviral agent famciclovir in combination with a short course of prostaglandin E in a patient with severe hepatitis B after liver transplantation. Initial treatment with prostaglandin E reduced the inflammatory activity, as measured by transaminase activities, but did not affect viral replication. Consecutive long-term treatment with famciclovir further normalized liver function and profoundly suppressed viral replication. HBeAg and HBV-DNA -PCR all became negative and only HBsAg persisted. Histology documented marked reduction of cellular infiltration. The patient completely recovered and is back to regular work as a teacher.
Department of Gastroenterology and Hepatology, Medizinische, Hochschule Hannover, Germany.
K H
KH
Böker
B
B
Ringe
M
M
Krüger
R
R
Pichlmayr
M P
MP
Manns
D015075:2-Aminopurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D004279:DNA, Viral / Q000032:analysis / Q000097:blood; D000077595:Famciclovir; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000097:blood / Q000188:drug therapy*; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D007249:Inflammation; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D011355:Prodrugs / Q000627:therapeutic use*; D011458:Prostaglandins E / Q000627:therapeutic use*; D014779:Virus Replication / Q000187:drug effects
D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D011355:Prodrugs; D011458:Prostaglandins E; D015075:2-Aminopurine; D000077595:Famciclovir