Danshao huaxian capsule in treatment of decompensated cirrhosis resulting from chronic hepatitis B.
BACKGROUND
The prognosis of decompensated cirrhosis resulting from chronic hepatitis B is poor, and the benefits of treatment with interferon are outweight serious side-effects and the risk of fatal exacerbation of disease. Danshao huaxian capsule rapidly reduces hepatitis B virus (HBV)-DNA in serum to undetectable levels.


METHODS
A total of 35 patients with chronic hepatitis B and decompensated cirrhosis were treated with danshao huaxian 1.2 g. p.o. tid daily. Before the treatment, HBV-DNA in serum was positive in all patients. Ten patients had Child-Pugh class B and 25, class C hepatitis B. Seven patients underwent liver transplantation within 6 months of initial treatment. Of the 10 patients of class B, 5 died within 6 months, and the other 5 did not complete the treatment for some reasons; the 25 patients of class C were treated for at least 6 months (mean=19 months).


RESULTS
In most of the 25 patients, liver function was improved slowly but markedly after 9 months of treatment, showing a decreased level of serum bilirubin from 67+/-13 to 30+/-4 micromol/L (P<0.05, baseline vs. 6 months), an increased level of serum albumin from 27+/-1 to 34+/-1 g/L (P<0.05) and a decreased level of Child-Pugh score from 10.3+/-0.4 to 7.5+/-0.5 (P<0.05). Three patients developed resistance to danshao huaxian because of a mutation in the YMDD motif, but liver function was not deteriorated. Inhibition of viral replication with danshao huaxian resulted in a significant improvement of liver function in patients with decompensated HBV cirrhosis, but the long-term results remain uncertain.


CONCLUSIONS
Danshao huaxian capsule is effective in inhibiting viral DNA replication in patients with decompensated cirrhosis and making clinical improvement.
Department of Infectious Diseases, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China. chengml@21cn.com
Ming-Liang
ML
Cheng
Tong
T
Lu
Yu-Mei
YM
Yao
Xiao-Xia
XX
Geng
D002214:Capsules; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014779:Virus Replication / Q000187:drug effects
D002214:Capsules; D004365:Drugs, Chinese Herbal; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D012367:RNA, Viral