Abstract
PurposeTo evaluate the short-term effect of lamivudine (LMV) treatment for severe chronic hepatitis B.MethodPatient data related to the safety and efficacy of using lamivudine (LMV) to treat hepatitis B virus (HBV)-induced liver failure or severe hepatitis were acquired from previous literature. These studies were retrieved from PubMed, Ovid, SpringerLink, Biosis Previews, Academic Search Premier, ProQuest Medical Library, Cochrane Library, China National Knowledge Infrastructure Full-text Database, VIP Chinese Scientific Journal Database, and Chinese Biomedicine. Relative risk and weighted mean difference were used to measure the effects. The major predictors observed included total bilirubin (TBIL), prothrombin activity (PTA), survival rate, and HBV-DNA negative change rate. Groups were further divided according to the clinical course and disease staging.ResultsA total of 242 studies were retrieved from the databases. At weeks 4, 8, and 12 of the treatment course, the survival rates and PTA of the test group were distinctively higher than those of the control group. However, TBIL concentrations in the test group were lower than the control group. The HBV-DNA negative change rate was distinctively higher throughout the 12 weeks of LMV treatment. For patients who started LMV treatment in the middle stage, the mortality rate of the test group was lower. For patients who started LMV treatment during the advanced stage, no significant difference was observed between the test and control groups.ConclusionLMV decreased HBV-DNA levels in the serum, improved liver function in patients, and enhanced survival rate during the early and medium stages of severe chronic hepatitis B.
Highlights
Severe hepatitis is a syndrome characterized by liver failure due to the death or severe degeneration of a large number of liver cells
total bilirubin (TBIL) concentrations in the test group were lower than the control group
The hepatitis B virus (HBV)-DNA negative change rate was distinctively higher throughout the 12 weeks of LMV treatment
Summary
Severe hepatitis is a syndrome characterized by liver failure due to the death or severe degeneration of a large number of liver cells. This severe, progressive, and complex syndrome frequently results in multiple organ failure. Various hepatitis virus types can lead to severe hepatitis. In China, hepatitis B virus (HBV) infection is the leading cause of severe hepatitis [4]. One of the important mechanisms of severe hepatitis is the high level of HBV replication and protein antigen expression on target improve liver function in patients. Other studies have reported that the increase of liver failure cases is attributed to lamivudine (LMV) use. HBV-related liver failure cannot be listed as the indication for LMV
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