1/2. Exacerbation of chronic hepatitis d during interferon alpha administration.Acute and severe impairment of liver function with jaundice and ascites occurred in two out of seven patients with chronic hepatitis d during interferon alpha administration (10 MU three times a week). Both of them were young women with histological diagnoses of moderate to severe chronic hepatitis and cirrhosis with no signs of portal hypertension. Only a slow and partial recovery was observed after interferon withdrawal. autoantibodies against basal cell layer tested positive in these two patients. In the remaining five patients with hepatitis d who did not experience liver impairment during interferon administration, basal cell layer antibodies were found only in one case. We conclude that severe decompensation of liver cirrhosis related to hepatitis d may occur during interferon administration. Positivity of basal cell layer antibodies may be associated with the risk of developing such an adverse event but our data are not sufficient to prove this association.- - - - - - - - - - ranking = 1keywords = decompensation (Clic here for more details about this article) |
2/2. The role of HBeAg seroconversion in acute exacerbation of liver disease with termination of hepatitis B and D virus infection in a chronic hepatitis d patient during alpha-interferon therapy.We report a severe flare-up in a chronic hepatitis patient due to dual infection with hepatitis B and D viruses during alpha-interferon therapy. Pre-treatment, the patient had detectable levels of both viruses. After 9 months of therapy, an alanine aminotransferase flare with acute hepatic decompensation was detected. Alpha-interferon was discontinued and lamivudine (100 mg once daily) was started, after which the patient reversed slowly. Hepatitis B early antigen (HBeAg) seroconversion with hepatitis b virus-dna clearance was observed 1 month after the flare; 15 months later, the patient had persistently normal alanine aminotransferase levels with negative results for both serum hepatitis b virus-dna and hepatitis d virus-rna. In conclusion, liver disease may be exacerbated during interferon therapy in patients with chronic hepatitis d who are also positive for hepatitis B surface antigen (HBsAg) and HBeAg. Therefore, extra care in monitoring should be considered and strict follow-up is recommended, since clearance of hepatitis d may occur after HBeAg seroconversion in coinfected patients. lamivudine may be administered early in hepatitis d-rna/HBsAg-positive patients at high risk of liver failure once a severe flare-up occurs during interferon therapy.- - - - - - - - - - ranking = 1keywords = decompensation (Clic here for more details about this article) |