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World J Gastroenterol. 2009 Apr 7;15(13):1650-2.

A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B.

Author information

1
Department of Internal Medicine, Mitoyo General Hospital, Kanonji, Japan.

Abstract

Of patients with severe exacerbation of chronic hepatitis B accompanied by jaundice and coagulopathy, 20%-30% have a fatal outcome. In this report, we describe 2 cases of severe exacerbation of chronic hepatitis B with jaundice and coagulopathy who were successfully treated with a combination of entecavir and corticosteroid. In both cases, rapid reductions in serum hepatitis B virus (HBV)-DNA levels were observed, and corticosteroid was stopped after serum HBV-DNA levels became undetectable. Entecavir treatment was continued. Generally, entecavir treatment reduced serum HBV-DNA levels rapidly, although the improvement in liver function was delayed by a few weeks. During this time lag, liver cell injury continued and the disease progressed. Corticosteroid suppressed the excessive host immune response and was useful for stopping progressive deterioration. A combination of entecavir and early-phase corticosteroid may be a useful treatment in severe exacerbation of chronic hepatitis B.

PMID:
19340912
PMCID:
PMC2669952
DOI:
10.3748/wjg.15.1650
[Indexed for MEDLINE]
Free PMC Article

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