Lamivudine therapy can be effective in treating chronic hepatitis B patients with hepatic decompensation, but effectiveness depends on patient bilirubin levels. This has been found by clinicians at Chang Gung University, Taipei, Taiwan, who investigate the effect of lamivudine therapy in hepatic decompensation during severe acute exacerbation (AE) of chronic hepatitis B (CHB).
The conditions can lead to hepatic decompensation and death. Over a 10 month period, the clinicians enrolled 60 consecutive AE patients with jaundice, with prolonged prothrombin time over 3s, who were treated with lamivudine at 150 mg daily. Controls were 31 CHB patients with AE which had resulted in their being hospitalised because of hepatic decompensation in the preceding six months.
Both groups of patients had comparable clinical and biochemical features. After a median treatment period six weeks (range 1 to 48 weeks), all of the 25 patients in the treatment group with bilirubin level before therapy of <20mg/dl survived. Five (25%) of 20 patients in the control group died. At the same time, the mortality rate was similar among patients with bilirubin level before therapy >/=20mg/dl in both groups.
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