Lamivudine treatment failure in preventing fatal outcome of de novo severe acute hepatitis B in patients with haematological diseases

Enzo Petrelli, Maria Balducci, Carlo Pieretti, Marco B Luigi Rocchi, Massimo Clementi, Aldo Manzin

Research output: Contribution to journalArticle

Abstract

Background: Patients with malignant haematological diseases administered or no longer receiving immunosuppressive therapy are at high risk of reactivation or de novo hepatitis B infection and fulminant hepatitis. Despite promising results in the treatment of chronic hepatitis and its use in selected patients with acute hepatitis B, there is no consensus on lamivudine treatment in severe acute hepatitis portending a fatal clinical outcome. Case reports: Of the ten patients with malignant haematological disorders who became infected with the same strain of hepatitis B virus during hospitalisation in a haematology ward, five received lamivudine (and in some cases, ganciclovir and famciclovir). The other patients received only supportive therapy, since deteriorating clinical conditions hampered specific treatment efforts. Eight patients died from acute liver failure and one from a fatal course of the haematological disease; one had a favourable outcome from the therapy. There was no significant difference in terms of survival between the treated and untreated patients. Conclusions: Although lamivudine has proved promising in the therapy of chronic hepatitis B and of recurrent hepatitis after liver transplantation, its use in de novo severe acute hepatitis should be investigated further, particularly in immunocompromised patients.

Original languageEnglish
Pages (from-to)823-826
Number of pages4
JournalJournal of Hepatology
Volume35
Issue number6
DOIs
Publication statusPublished - 2001

Keywords

  • Fulminant hepatitis B
  • Haematological diseases
  • Lamivudine
  • Survival

ASJC Scopus subject areas

  • Gastroenterology

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