Management of Fulminant Hepatitis Induced by Viral Infection
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Accession number;05A0313189
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| Title;Management of Fulminant Hepatitis Induced by Viral Infection |
| Author;
GUNJI TOSHIAKI
(Univ. Tokyo, Univ. Hospital)
OMATA MASAO
(Univ. Tokyo, Univ. Hospital)
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Journal Title;Japanese Journal of Intensive Care Medicine
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Journal Code:Z0581B
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ISSN:0389-1194
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VOL.29;NO.2;PAGE.117-122(2005)
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| Figure&Table&Reference;TBL.1, REF.9 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Fulminant hepatitis (FH) is defined as a clinical syndrome of severe liver dysfunction, which causes hepatic coma within 8 weeks of onset, with a high risk of developing cerebral edema, sepsis, GI bleeding and multi-organ failure. Subclassification of FH into acute and subacute hepatic failure carries a prognostic significance. The best chance of survival is gained in acute FH group, whereas the mortality is significantly higher in subacute FH group. About half of FH is due to hepatitis virus infection. In these viral FH patients HBV-related FH is most prevalent in Japan, which occurs through acute HBV infection or HBV reactivation on asymptomatic carrier. In carriers of HBV, viral reactivation leading to FH can occur after withdrawal of immunosuppressive agents as well as spontaneous flare. With the availability of liver transplantation, the outcome of FH has improved in recent years. However, in Japan, where liver transplantation is not widely available because of the shortage of the organs, it is important to care FH patients by intensive supportive treatments including liver assist devices (plasma exchange and/or hemodiafiltration), immunosuppressive agents (corticosteroid) and antiviral therapy (interferon and/or lamivudine). Lamivudine is a potent inhibitor of HBV replication, and is an effective and lifesaving treatment for FH with HBV infection. Prompt use of lamivudine is recommended for the management of HBV FH. (author abst.) |
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