Corticosteroid and nucleoside analogue for hepatitis B virus-related acute liver failure

doi:10.3748/wjg.v21.i36.10485

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World Journal of Gastroenterology

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1007-9327

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Letter to the Editor

World J Gastroenterol. Sep 28, 2015; 21(36): 10485-10486
Published online Sep 28, 2015. doi: 10.3748/wjg.v21.i36.10485

Corticosteroid and nucleoside analogue for hepatitis B virus-related acute liver failure

Keiichi Fujiwara, Shin Yasui, Osamu Yokosuka

Keiichi Fujiwara, Shin Yasui, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan

Author contributions: Fujiwara K and Yokosuka O designed research; Fujiwara K and Yasui S performed research; Fujiwara K and Yasui S analyzed data; Fujiwara K wrote the letter; and Fujiwara K revised the letter.

Conflict-of-interest statement: Osamu Yokosuka has received research funding from Chugai Pharma.

Correspondence to: Keiichi Fujiwara, MD, PhD, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Chiba, Japan. fujiwara-cib@umin.ac.jp

Telephone: +81-43-2262083 Fax: +81-43-2262088

Received: March 10, 2015
Peer-review started: March 11, 2015
First decision: April 13, 2015
Revised: April 16, 2015
Accepted: June 10, 2015
Article in press: June 10, 2015
Published online: September 28, 2015
Processing time: 201 Days and 19.4 Hours

Abstract

The early introduction of combination therapy of high-dose corticosteroid and nucleoside analogue is beneficial for the rescue of severe acute exacerbation of chronic hepatitis B.

Keywords: Chronic hepatitis B; Exacerbation; Acute liver failure; Nucleoside analogue; Corticosteroid

Core tip: Nucleoside analogues generally need some weeks before hepatitis B virus DNA becomes undetectable and therefore they may be too slow to influence the clinical course of acute severe liver failure, and the overwhelming anti-viral immune response might actively contribute to the effectiveness of treatment. We have performed prospective study of early introduction of high-dose corticosteroid with/without nucleoside analogue for severe acute reactivation of chronic hepatitis B since 1997, and recovery rate without liver transplantation improved from 25% to 70%.