Efficacy of antiviral therapy in the treatment of severe forms of acute hepatitis B

Aim of work: to prove necessity and safety of antiviral treatment with nucleoside analogues for severe form of acute hepatitis B.

Materials and methods: The study involved 137 patients with severe form of acute hepatitis B, established by results of the identification of markers of hepatitis B virus. In 75 patients (54%) recorded the initial signs of acute hepatic encephalopathy, which were indications of hospitalization in intensive care unit. The treatment of 25 patients included nucleoside analog: telbivudine (600 mg/day) or entecavir (0,5 mg/day) – the main group. The method of «case – control» matched 25 patients in the comparison group who did not receive antiviral drugs. Monitoring of clinical and biochemical parameters were carried out once a week, the viral load – at the start of antiviral therapy and 4 weeks later.

Results: In the main group noted rapid relief of major clinical symptoms of the disease (within 3–6 days). ALT levels in the main group was significantly decreased after a week of antiviral therapy, after four – reached 43,6 ± 18,7 U/L. The concentration of bilirubin in three weeks of therapy in the main group became significantly lower (p ≤ 0,05), than in the comparison group (38,0 ± 15,0 and 130,3 ± 105,1 mmol / L, respectively). After four weeks of antiviral therapy viral load decreased twice (p = 0.0001). Adverse events were not marked.

Conclusion: Inclusion in the basic therapy antiviral agents allows halving the duration of stay of the patient in the intensive care unit, to prevent death, to achieve a significant improvement in laboratory parameters, in the absence of adverse events.

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