Abstract
New concepts for the treatment of hepatitis B in immunocompromised patients are urgently needed. We describe our first experience with the new antiviral agent famciclovir in combination with a short course of prostaglandin E in a patient with severe hepatitis B after liver transplantation. Initial treatment with prostaglandin E reduced the inflammatory activity, as measured by transaminase activities, but did not affect viral replication. Consecutive long-term treatment with famciclovir further normalized liver function and profoundly suppressed viral replication. HBeAg and HBV-DNA -PCR all became negative and only HBsAg persisted. Histology documented marked reduction of cellular infiltration. The patient completely recovered and is back to regular work as a teacher.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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2-Aminopurine / analogs & derivatives*
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2-Aminopurine / therapeutic use
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Antiviral Agents / therapeutic use*
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Carcinoma, Hepatocellular / surgery
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DNA, Viral / analysis
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DNA, Viral / blood
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Famciclovir
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Follow-Up Studies
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Hepatitis B / blood
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Hepatitis B / drug therapy*
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Hepatitis B e Antigens / blood
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Hepatitis B virus / genetics
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Hepatitis B virus / isolation & purification
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Hepatitis B virus / physiology
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Humans
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Inflammation
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Liver Function Tests
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Liver Neoplasms / surgery
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Liver Transplantation*
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Male
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Middle Aged
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Polymerase Chain Reaction / methods
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Prodrugs / therapeutic use*
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Prostaglandins E / therapeutic use*
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Virus Replication / drug effects
Substances
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Antiviral Agents
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DNA, Viral
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Hepatitis B e Antigens
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Prodrugs
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Prostaglandins E
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2-Aminopurine
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Famciclovir