Efficacy Of Lamivudine On Acute-on-chronic Liver Failure In Patients With Chronic Hepatitis B

Objective To observe therapeutic effects of lamivudine on patientswith early-to-mid stage Hepatitis B virus related acute-on-chronic liverfailure (HBV-ACLF).The follow-up endpoint was48weeks.Methods Clinical data in hospitalized patients with HBV-ACLF wereretrospectively analyzed. Prothrombin time active (PTA), alanineaminotransferase (ALT), aspartate aminotransferase(AST), albumin (Alb),total bilirubin (TBil), HBV-DNA, model for end-stage liver disease (MELD)score, serum creatinine(Cr), blood urea nitrogen (BUN), adverse reactionwere fulfilled at week4,8,24,48respectively.Results (1) At week4、8、24and48,the complete virologic responserate were57.53%（42/73）、70.97%（44/62）、83.05%（49/59）and86.54%（45/52）respectively; the partial virologic response rate were30.14%（22/73）、25.81%（16/62）、16.95%（10/59）and13.46%（7/52）respectively.(2) At follow-up endpoint, the survival rate was71.23%（52/73）. At48weeks the probability of survival was higher in the complete virologicresponse group than in the partial virologic response group (45/73[61.64%] versus7/73[30.14%], respectively; P=0.000).(3) A significantimprovement was observed in the serum normalization rate of HBV-DNA,ALT, AST, Alb, TBil, PTA and MELD score in survival patients comparedto baseline (P<0.05). At the48week, MELD score was improved markedlyin the complete virologic response group compared with the partialvirologic group.Conclusion Antiviral therapy by using lamivudine may be aneffective therapeutic option for patients with acute-on-chronic hepatitis Bliver failure.