계명대학교 의학도서관 Repository

Tenofovir, entecavir, and lamivudine in patients with severe acute exacerbation and hepatic decompensation of chronic hepatitis B

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Author(s)
Jung Gil ParkYu Rim LeeSoo Young ParkHeon Ju LeeWon Young TakYoung Oh KweonSe Young JangJae Min ChunYoung Seok HanKeun HurHye Won LeeMin Kyu Kang
Keimyung Author(s)
Lee, Hye Won
Department
Dept. of Pathology (병리학)
Journal Title
Digestive and Liver Disease
Issued Date
2018
Volume
50
Issue
2
Keyword
Acute exacerbationChronic hepatitis BEntecavirLamivudineTenofovir
Abstract
OBJECTIVE:
To compare the efficacy of and mortality after lamivudine (LAM), tenofovir (TDF), and entecavir (ETV) treatment in patients with severe acute chronic hepatitis B (CHB) exacerbation.

METHODS:
We analyzed 91 patients with severe acute CHB exacerbation treated with LAM (n=28), TDF (n=26), or ETV (n=37) for 10 years. The primary endpoint was overall mortality or liver transplantation (LT) by 48 weeks. The determined predictors of mortality, virologic and biochemical responses, and drug resistance were also evaluated.

RESULTS:
The overall mortality or LT rate was not significantly different among the LAM (14.3%), ETV (10.8%), and TDF (3.8%) groups (P=0.435). In the multivariate analysis, the occurrence of ascites (hazard ratio [HR] 10.467, 95% confidence interval [CI] 1.596-68.645, P=0.014) and model for end-stage liver disease (MELD) scores above 25 (HR 28.920, CI 4.719-177.251, P=0.000) increased the risk of mortality or LT. All groups showed similar biochemical responses (P=0.134), virologic responses (HBV DNA <116copies/mL, P=0.151), and HBeAg seroconversion (P=0.560). Antiviral resistance emerged in five patients treated with LAM by 48 weeks (17.9%, P=0.003).

CONCLUSION:
LAM, ETV, and TDF selection is not related with mortality and LT in patients with severe acute CHB exacerbation and hepatic decompensation. To reduce mortality, patients with ascites and MELD scores above 25 should be considered for LT.
Keimyung Author(s)(Kor)
이혜원
Publisher
School of Medicine (의과대학)
Citation
Jung Gil Park et al. (2018). Tenofovir, entecavir, and lamivudine in patients with severe acute exacerbation and hepatic decompensation of chronic hepatitis B. Digestive and Liver Disease, 50(2), 163–167. doi: 10.1016/j.dld.2017.10.002
Type
Article
ISSN
1590-8658
Source
https://linkinghub.elsevier.com/retrieve/pii/S1590865817312537
DOI
10.1016/j.dld.2017.10.002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41502
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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