title: Combined glucocorticoid and antiviral therapy of hepatitis B virus-related liver failure.
abstract: Acute hepatic failure due to hepatitis B virus (HBV) can occur both during primary infection as well as after reactivation of chronic infection. Guidelines recommend considering antiviral therapy in both situations, although evidence supporting this recommendation is weak. Since HBV is not directly cytopathic, the mechanism leading to fulminant hepatitis B is thought to be primarily immune-mediated. Therefore, immunosuppression combined with antiviral therapy might be a preferred therapeutic intervention in acute liver failure in hepatitis B. Here we report our favourable experience in three hepatitis B patients with fulminant hepatic failure who were treated by combining high-dose steroid therapy with standard antiviral treatment, which resulted in a rapid improvement of clinical and liver parameters.
authors.affiliation: Jan-Hendrik Bockmann, Maura Dandri, Stefan Lüth, Nadine Pannicke, Ansgar W Lohse, 1 Deparment of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Jan-Hendrik
authors.initials: JH
authors.lastname: Bockmann
authors.affiliation: Jan-Hendrik Bockmann, Maura Dandri, Stefan Lüth, Nadine Pannicke, Ansgar W Lohse, 1 Deparment of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Maura
authors.initials: M
authors.lastname: Dandri
authors.affiliation: Jan-Hendrik Bockmann, Maura Dandri, Stefan Lüth, Nadine Pannicke, Ansgar W Lohse, 1 Deparment of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Lüth
authors.affiliation: Jan-Hendrik Bockmann, Maura Dandri, Stefan Lüth, Nadine Pannicke, Ansgar W Lohse, 1 Deparment of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Nadine
authors.initials: N
authors.lastname: Pannicke
authors.affiliation: Jan-Hendrik Bockmann, Maura Dandri, Stefan Lüth, Nadine Pannicke, Ansgar W Lohse, 1 Deparment of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Ansgar W
authors.initials: AW
authors.lastname: Lohse
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D003952:Diagnostic Imaging; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents
keywords: Acute liver failure; Hepatitis B virus; Prednisolone; Reactivation; Rituximab