Lamivudine treatment improves the prognosis of fulminant hepatitis B.
OBJECTIVE
The efficacy of lamivudine for fulminant hepatitis B has been reported in Europe and West Asia. However, in these reports, the main infection genotype is D. Furthermore, if lamivudine improves survival, prognostic factors for fulminant hepatitis B may differ from those reported previously. The aim of this study was to clarify the prognostic factors and the efficacy of lamivudine for fulminant hepatitis B in Japan, where the main infection genotype is B.


METHODS
This study was a retrospective cohort study. We selected 37 consecutive patients with fulminant hepatitis due to acute hepatitis B virus infection. As 4 of them had received liver transplantation, the data of 33 patients with a median age of 45 (range, 20-74) years were analyzed.


RESULTS
Lamivudine was administered to 10 patients. There were no differences in clinical features at the time of the diagnosis of fulminant hepatitis B between patients treated with and without lamivudine. Survival rates of patients treated with and without lamivudine were 70% and 26%, respectively. Age (> or =45 years), systemic inflammatory response syndrome, and non-administration of lamivudine were associated with fatal outcomes. The survival rates of patients treated with and without lamivudine, who were in a state of systemic inflammatory response syndrome, were 50% and 9%, and in patients aged > or =45 years, 50% and 8%, respectively.


CONCLUSIONS
This study suggests the efficacy of lamivudine for fulminant hepatitis B in the area where the main infection genotype is B. We consider that lamivudine is worth administering to patients with fulminant hepatitis B.
Miyake
Yasuhiro
Y
Department of Gastroenterology & Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences. miyakeyasuhiro@hotmail.com
Iwasaki
Yoshiaki
Y
Takaki
Akinobu
A
Fujioka
Shin-ichi
S
Takaguchi
Kouichi
K
Ikeda
Hiroshi
H
Kobashi
Haruhiko
H
Sakaguchi
Kohsaku
K
Shiratori
Yasushi
Y
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy*; D006515:Hepatitis B virus; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D017114:Liver Failure, Acute / Q000188:drug therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy
D000998:Antiviral Agents; D019259:Lamivudine