[Favorable course of hepatitis B virus reactivation with hepatocellular insufficiency by a treatment combining corticoids, foscarnet and ganciclovir].
Reactivation of hepatitis B virus replication is a rare event during the natural history of chronic hepatitis B. However, the clinical presentation may be severe and an effective therapeutic protocol must be established. We report a case of spontaneous reactivation of hepatitis B virus infection with liver failure. For the moment, no medical treatment has been defined in this situation. A combination of corticosteroids and antiviral drugs (foscarnet and ganciclovir) resulted in clinical and biological recovery, and HBV elimination. If the efficacy of this combined treatment is confirmed in a larger population, this new physiopathological approach should be considered whenever life threatening liver failure occurs.
Dumortier
J
J
Service d'Hépatologie, Hôtel-Dieu, Lyon.
Durupt
S
S
Chevallier
M
M
Trépo
C
C
Zoulim
F
F
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006515:Hepatitis B virus / Q000254:growth & development; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D017093:Liver Failure / Q000188:drug therapy* / Q000209:etiology; D008775:Methylprednisolone / Q000627:therapeutic use*; D014775:Virus Activation / Q000187:drug effects*
D000998:Antiviral Agents; D005938:Glucocorticoids; D017245:Foscarnet; D015774:Ganciclovir; D008775:Methylprednisolone
Evolution favorable d'une réactivation du virus de l'hépatite B avec insuffisance hépatocellulaire grâce à un traitement associant corticoïdes, foscarnet, et ganciclovir.