title: [Lamivudine and entecavir significantly improved the prognosis of early-to-mid stage hepatitis B related acute on chronic liver failure].
abstract: OBJECTIVE
  To clinically study the antiviral effects of lamivudine and entecavir on patients with early-to-mid stage Hepatitis B related acute on chronic liver failure (HBV-ACLF). METHODS; A prospective, randomized, open and parallel controlled clinical trial was designed to observe the antiviral effects of nucleoside analogues on patients with early-to-mid stage HBV-ACLF. Three groups were set for controlled study, i. e. basic treatment group, lamivudine plus basic treatment group and entecavir plus basic treatment group.
  
  
  RESULTS
  One month after treatment, the improvement rates of lamivudine group and entecavir group were 58.85% and 59.15% respectively, significantly higher than that of basic treatment group which was 34.84% (Chi(2) = 9.8323, P = 0.043). By the end of six months, the cumulative survival rates of patients with the antiviral treatments, i.e., lamivudine, entecavir, were 65.8%, 60.1%, significantly higher than that (42%) without the antiviral treatment (P = 0.045, P = 0.04 respectively). The cumulative survival rate in patients with a MELD score < 30 was higher than that with a MELD score over 30 (Chi(2) = 3.920, P = 0.048). For the patients with pretreatment HBV DNA > or = 10(7), the cumulative survival rate in patients with entecavir treatments group was higher than that of patients in basic treatment group (Chi(2) = 5. 014 P= 0.025). According to the Ordinal Regression analysis, antiviral therapy by using either lamivudine or entecavia could significantly increase the improvement rate of patients with early-to-mid stage HBV-ACLF. But severe complications, including hepatorenal syndrome, electrolyte imbalance and hepatic encephalopathy, medical history of liver cirrhosis, and pretreatment HBV DNA > or = 10(7) had significant impacts on prognosis of this group patients.
  
  
  CONCLUSIONS
  Antiviral therapy by using either lamivudine or entecavia could significantly increase the survival rate of patients with early-to-mid stage HBV-ACLF.
authors.affiliation: Liver Failure Treatment and Research Center, 302 Hospital of PLA, Beijing, China.
authors.forename: Jin-hua
authors.initials: JH
authors.lastname: Hu
authors.forename: Hui-fen
authors.initials: HF
authors.lastname: Wang
authors.forename: Wei-ping
authors.initials: WP
authors.lastname: He
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Liu
authors.forename: Ning
authors.initials: N
authors.lastname: Du
authors.forename: Kun
authors.initials: K
authors.lastname: Huang
authors.forename: Jin-biao
authors.initials: JB
authors.lastname: Ding
authors.forename: Xue-zhang
authors.initials: XZ
authors.lastname: Duan
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Ju-mei
authors.initials: JM
authors.lastname: Chen
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004198:Disease Susceptibility; D058625:End Stage Liver Disease / Q000139:chemically induced; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use*; D011379:Prognosis
chemical_list: D019380:Anti-HIV Agents; D019259:Lamivudine; C413685:entecavir; D006147:Guanine