title: A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Mitoyo General Hospital, Kanonji, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Miyatake
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takahara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Imada
authors.forename: Satoru
authors.initials: S
authors.lastname: Yagi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Toyokawa
authors.forename: Morihito
authors.initials: M
authors.lastname: Nakatsu
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ando
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hirohata