Abstract
Severe acute exacerbation or liver failure induced by standard interferon-α(IFN-α) therapy had been reported to occur in few patients with chronic hepatitis B. However, no report showed that pegylated interferon-α therapy was able to induce severe acute exacerbation of chronic hepatitis B. Here, we describe three patients with severe acute exacerbation of chronic hepatitis B during pegylated interferon-α2a (Pegasys) treatment. One patient progressed into acute-on-chronic liver failure (ACLF) at the second week of Pegasys treatment. Two patients progressed into acute-on-chronic pre-liver failure (pre-ACLF) at the second and eighth week of Pegasys treatment, respectively. Three patients recovered after early combined intervention with corticosteroid and lamivudine. Our data indicated that there was a risk of severe acute exacerbation among patients with chronic hepatitis B during receiving Pegasys treatment. Importantly, early combined intervention with corticosteroid and lamivudine should be introduced to prevent the disease progression and improve their prognosis once severe acute exacerbation was diagnosed.
Highlights
It is estimated that over 350 million people worldwide are chronically infected with hepatitis B virus (HBV)
Patients with severe acute exacerbation tend to have a higher risk for progression to acute-on-chronic liver failure (ACLF) with extremely high mortality [5,6]
Severe acute exacerbation or ACLF induced by standard interferon-α therapy had been reported to occur in few patients with chronic hepatitis B [3,4]
Summary
It is estimated that over 350 million people worldwide are chronically infected with hepatitis B virus (HBV). We introduced three patients with severe acute exacerbation of chronic hepatitis B during Pegasys treatment, including two patients with pre-ACLF and one patient with ACLF.
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