A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B.
Of patients with severe exacerbation of chronic hepatitis B accompanied by jaundice and coagulopathy, 20%-30% have a fatal outcome. In this report, we describe 2 cases of severe exacerbation of chronic hepatitis B with jaundice and coagulopathy who were successfully treated with a combination of entecavir and corticosteroid. In both cases, rapid reductions in serum hepatitis B virus (HBV)-DNA levels were observed, and corticosteroid was stopped after serum HBV-DNA levels became undetectable. Entecavir treatment was continued. Generally, entecavir treatment reduced serum HBV-DNA levels rapidly, although the improvement in liver function was delayed by a few weeks. During this time lag, liver cell injury continued and the disease progressed. Corticosteroid suppressed the excessive host immune response and was useful for stopping progressive deterioration. A combination of entecavir and early-phase corticosteroid may be a useful treatment in severe exacerbation of chronic hepatitis B.
Matsumoto
Kazuyuki
K
Department of Internal Medicine, Mitoyo General Hospital, Kanonji, Japan.
Miyake
Yasuhiro
Y
Miyatake
Hirokazu
H
Takahara
Masahiro
M
Imada
Takayuki
T
Yagi
Satoru
S
Toyokawa
Tatsuya
T
Nakatsu
Morihito
M
Ando
Masaharu
M
Hirohata
Mamoru
M