https://scholars.lib.ntu.edu.tw/handle/123456789/521244
標題: | Acute hepatic failure caused by hepatitis B virus reactivation in patients receiving immunomodulatory agents for autoimmune diseases | 作者: | Hsu S.-Y. CHENG-MAW HO PO-HUANG LEE HONG-SHIEE LAI REY-HENG HU |
公開日期: | 2014 | 出版社: | Turkish League Against Rheumatism (TLAR) | 卷: | 29 | 期: | 3 | 起(迄)頁: | 171-177 | 來源出版物: | Turkish Journal of Rheumatology | 摘要: | Objectives: The increasing use of novel immunomodulators, such as rituximab, leflunomide and adalimumab in the treatment of autoimmune diseases may put hepatitis B virus (HBV) carriers at increased risk for reactivation and consequent hepatic failure.Patients and methods: We assessed 164 patients newly registered as liver transplant candidates at the National Taiwan University Hospital in 2010. Four patients (2.4%) also had underlying autoimmune disease and received immunomodulatory therapy which resulted in HBV reactivation and acute liver failure, which manifested as progressive hyperbilirubinemia and coagulopathy. The median time of survival of these patients was estimated using the Kaplan-Meier method.Conclusion: Prophylactic anti-HBV medication is recommended for HBV carriers with autoimmune diseases who are prescribed immunomodulatory agents for preventing catastrophic consequences such as acute liver failure caused by HBV reactivation.Results: All four patients were previously healthy HBV carriers with e antigen seroconversion.The mean peak alanine aminotransferase level was 3194.5±937.7 U/L. Entecavir was administered for an average of 39.8±10.5 days after the onset of the symptomatic hepatic dysfunction. Three patients who were experienced complications such as hepatic encephalopathy died. Only one patient survived liver failure. The median survival time after HBV reactivation and acute liver failure was 74.0 days (95% confidence interval, 31.9 to 116.1 days). The cumulative survival rate after HBV reactivation within three months was 25%. ?2014 Turkish League Against Rheumatism. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84907797378&doi=10.5606%2fArchRheumatol.2014.3822&partnerID=40&md5=2a3814f496838dcc6abba7961e28c8c9 https://scholars.lib.ntu.edu.tw/handle/123456789/521244 |
ISSN: | 1309-0291 | DOI: | 10.5606/ArchRheumatol.2014.3822 | SDG/關鍵字: | adalimumab; alanine aminotransferase; aspartate aminotransferase; azathioprine; bilirubin; entecavir; etanercept; hepatitis E antigen; hydroxychloroquine; immunomodulating agent; lamivudine; leflunomide; liver enzyme; methotrexate; methylprednisolone sodium succinate; prednisolone; rituximab; salazosulfapyridine; acute liver failure; adult; alanine aminotransferase blood level; ankylosing spondylitis; antiphospholipid syndrome; appetite disorder; arthralgia; Article; autoimmune disease; blood clotting disorder; death; dizziness; drug substitution; female; hepatic encephalopathy; hepatitis B; Hepatitis B virus; human; hyperbilirubinemia; jaundice; liver dysfunction; liver transplantation; major clinical study; malaise; male; middle aged; nausea; rheumatoid arthritis; seroconversion; skin discoloration; survival rate; survival time; Taiwan; university hospital; unspecified side effect; virus carrier; virus reactivation; vomiting; xerostomia |
顯示於: | 醫學系 |
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