Importance of adequate immunosuppressive therapy for the recovery of patients with “life-threatening” severe exacerbation of chronic hepatitis B

Table 1 Clinical features of patients.

Pt	Age (yr)	Sex	Therapy drug	Duration (d)1	Condition	History of immunosuppresive or cytotoxic therapy	Outcome
Patients who received early introduction of high-dose corticosteroids
1.	27	M	MPSL/PSL	1	Ulcerative colitis	+	Death
2.	36	M	PSL	2		-	Re covery
3.	41	F	PSL	3		-	Recovery
4.	27	M	PSL	4		-	Recovery
5.	41	F	PSL	4	Schizophrenia	-	Recovery
6.	33	M	PSL+Lam	4		-	Recovery
7.	68	F	PSL+Lam	4	Non-Hodgkin’s lymphoma	+	Recovery
8.	56	M	PSL	5		-	Recovery
9.	57	F	PSL	5		-	Recovery
10.	39	M	PSL	5	Acute lymphocytic leukemia	+	Recovery
11.	43	M	PSL	10		-	Recovery
Patients who did not receive early introduction of high-dose corticosteroids
12.	49	F	PSL+IFN	14	Non-Hodgkin’s lymphoma	+	Death
13.	59	F	PSL	14		-	Death
14.	47	M	PSL+Lam	14	Ulcerative colitis	+	Death
15.	58	M	PSL	15		-	Death
16.	59	M	PSL	17		-	Death
17.	36	F	MPSL/PSL+IFN	28	Breast cancer	+	Death
18.	68	F	PSL	120	Pemphigoid	+	Death
19.	41	M	glycyrrhizin			-	Recovery
20.	55	M	glycyrrhizin			-	Recovery
21.	59	M	glycyrrhizin			-	Death
22.	28	M	glycyrrhizin		Mental retardation	-	Death

PSL: prednisolone, MPSL: methylprednisolone, IFN: interferon, Lam: lamivudine. 1Duration between the diagnosis of severe disease and introduction of immunosuppressive drugs.

Table 2 Biochemical and histological features of patients at admission.

Pt	PT(%)	ALT(IU/L)	T-bili(mg/dL)	HBeAg/HBeAb	IgM-HBc(cut-off index)	HBV DNApolymerase (cpm)	HBV DNA(Meq/mL)	Liver histology
Patients who received early introduction of high-dose corticosteroids
1.	16	1698	9.5	-/+	2.6	10	ND	ND
2	31	2689	3	+/-	0.3	3517	ND	ND
3	57	474	15.2	-/+	0.2	50	<0.70	ND
4	37	495	12.0	+/-	0.3	999	920 pg/mL	CAH (F2, severe)
5	37	155	8	-/-	0.5	ND	1+	ND
6	56	2080	4.2	+/+	1.8	595	<0.70	CAH (F2, severe)
7	57	167	3.1	-/+	ND	6425	ND	ND
8.	37	2257	3.7	-/+	2.3	28	20	CAH (F3, severe)
9	34	224	7.3	+/-	1.4	25	1.2	ND
10	56	399	3.8	-/+	3.7	11600	ND	Submassive necrosis
11	46	101	6.4	-/+	0.3	10	<0.70	LC, submassive necrosis
Patients who did not receive early introduction of high-dose corticosteroids
12	29	254	12.6	-/+	1.1	0	<0.70	ND
13.	34	2 643	19.3	+/-	1.6	0	<0.70	ND
14.	32	240	2.9	-/+	0.5	12735	3800	ND
15	28	228	13.3	-/+	3.3	16	1.1	Submassive necrosis
16.	29	150	13.3	-/+	0.2	53856	>10000	Submassive necrosis
17	19	549	11.1	+/-	7.6	2	1.9	LC, submassive necrosis
18	28	954	6.3	-/+	ND	ND	ND	Submassive necrosis
19.	59	214	12.9	+/+	0.4	5	ND	CAH (F3, moderate)
20	38	3620	7.7	-/+	0.2	0	<0.70	CAH (F3, moderate)
21.	33	164	8.9	+/-	ND	7576	ND	LC, submassive necrosis
22.	21	49	8.0	+/-	1.0	0	<0.70	Submassive necrosis

CAH: chronic active hepatitis; LC: liver cirrhosis; ND: not done.