Chapter 34
Treatment of Acute Hepatitis, Severe Acute Hepatitis, and Acute Liver Failure
Hans L. Tillmann,
Alastair D. Smith,
Hans L. Tillmann
Division of Gastroenterology, Duke University, Durham, NC, USA
Search for more papers by this authorAlastair D. Smith
Division of Gastroenterology, Duke University, Durham, NC, USA
Search for more papers by this authorHans L. Tillmann,
Alastair D. Smith,
Hans L. Tillmann
Division of Gastroenterology, Duke University, Durham, NC, USA
Search for more papers by this authorAlastair D. Smith
Division of Gastroenterology, Duke University, Durham, NC, USA
Search for more papers by this authorBook Editor(s):Howard C. Thomas BSc, PhD, FRCP, FRCPath, FMedSci,
Anna S.F. Lok MD,
Stephen A. Locarnini MBBS, BSc(Hons), PhD, FRCPath,
Arie J. Zuckerman MD, DSc, FRCP, FRCPath, FMedSci,
Howard C. Thomas BSc, PhD, FRCP, FRCPath, FMedSci
Emeritus Professor of Hepatology, Department of Medicine, Imperial College London, London, UK
Search for more papers by this authorAnna S.F. Lok MD
Alice Lohrman Andrews Research Professor in Hepatology, Director of Clinical Hepatology, Professor of Internal Medicine, Associate Chair for Clinical Research, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
Search for more papers by this authorStephen A. Locarnini MBBS, BSc(Hons), PhD, FRCPath
Head, Research & Molecular Development, Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia
Search for more papers by this authorArie J. Zuckerman MD, DSc, FRCP, FRCPath, FMedSci
Emeritus Professor of Medical Microbiology, Formerly Principal and Dean, Royal Free Hospital School of Medicine
Search for more papers by this authorFirst published: 26 July 2013
Summary
All hepatitis viruses can cause acute liver failure. For mild acute hepatitis, treatment is indicated only for acute hepatitis C virus (HCV), due to its high rate of chronicity if untreated, although in patients predicted to have a high chance of spontaneous clearance, a 12-week observation seems reasonable. Antiviral therapy is recommended for patients with severe acute hepatitis or acute liver failure due to hepatitis B virus (HBV). Causal treatment is not available for many types of acute liver failure. Patients with severe acute hepatitis and early signs of acute liver failure should be referred to liver transplant centers as early as possible.
References
- American Association for the Study of Liver Diseases (AASLD). Practice guidelines. 2011 [cited 2013 Feb 1]. Available from: http://www.aasld.org/practiceguidelines/Documents/AcuteLiverFailureUpdate2011.pdf
- Bernal W, Auzinger G, Dhawan A, Wendon J. Acute liver failure. Lancet 2010; 376: 190–201.
- Lemon SM. Type A viral hepatitis: epidemiology, diagnosis, and prevention. Clin Chem 1997; 43: 1494–1499.
- US Centers for Disease Control and Prevention (CDC). Surveillance for acute viral hepatitis – United States, 2005. MMWR Surv Summ 2007; 56(SS03): 1–24. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5603a1.htm
- Cooksley WG. What did we learn from the Shanghai hepatitis A epidemic? J Viral Hepat 2000; 7(Suppl 1): 1–3.
- Vento S, Garofano T, Renzini C, et al. Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C. N Engl J Med 1998; 338: 286–290.
- Fujiwara K, Kojima H, Yasui S, et al. Hepatitis A viral load in relation to severity of the infection. J Med Virol 2011; 83: 201–207.
- Ajmera V, Xia G, Vaughan G, et al. What factors determine the severity of hepatitis A-related acute liver failure? J Viral Hepat 2011; 18: e167–e174.
- Widell A, Hansson BG, Oberg B, Nordenfelt E. Influence of twenty potentially antiviral substances on in vitro multiplication of hepatitis A virus. Antiviral Res 1986; 6: 103–112.
- Crance JM, Biziagos E, van Passagot J, Cuyck-Gandré H, Deloince R. Inhibition of hepatitis A virus replication in vitro by antiviral compounds. J Med Virol 1990; 31: 155–160.
- Park GC, Hwang S, Yu YD, et al. Intractable recurrent hepatitis A virus infection requiring repeated liver transplantation: a case report. Transplant Proc 2010; 42: 4658–4660.
- Komiya Y, Katayama K, Yugi H, et al. Minimum infectious dose of hepatitis B virus in chimpanzees and difference in the dynamics of viremia between genotype A and genotype C. Transfusion 2008; 48: 286–294.
- Hsia CC, Purcell RH, Farshid M, Lachenbruch PA, Yu MY. Quantification of hepatitis B virus genomes and infectivity in human serum samples. Transfusion 2006; 46: 1829–1835.
- Tillmann HL, Zachou K, Dalekos GN. Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat? Liver Int 2012; 32: 544–553.
- Hovi L, Saarinen UM, Jalanko H, Pohjanpelto P, Siimes MA. Characteristics and outcome of acute infection with hepatitis B virus in children with cancer. Pediatr Infect Dis J 1991; 10: 809–812.
- Walsh JH, Purcell RH, Morrow AG, Chanock RM, Schmidt PJ. Posttransfusion hepatitis after open-heart operations: incidence after the administration of blood from commercial and volunteer donor populations. JAMA 1970; 211: 261–265.
- Oliphant JW. Jaundice following administration of human serum. Bull NY Acad Med 1944; 20: 429–445.
- CDC. Notes from the field: deaths from acute hepatitis B virus infection associated with assisted blood glucose monitoring in an assisted-living facility – North Carolina, August–October 2010. MMWR 2011; 60: 182. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6006a5.htm
- CDC. Surveillance for acute viral hepatitis – United States, 2005. MMWR Surv Summ 2007; 56: 1–24. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5603a1.htm
- Ostapowicz G, Fontana RJ, Schiødt FV, et al. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med 2002; 137: 947–954.
- Michitaka K, Horiike N, Chen Y, et al. Infectious source factors affecting the severity of sexually transmitted acute hepatitis due to hepatitis B virus genotype C. Intervirology 2005; 48: 112–119.
- Sainokami S, Abe K, Sato A, et al. Initial load of hepatitis B virus (HBV), its changing profile, and precore/core promoter mutations correlate with the severity and outcome of acute HBV infection. J Gastroenterol 2007; 42: 241–249.
- Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology 2009; 50: 661–662.
- Kumar M, Satapathy S, Monga R, et al. A randomized controlled trial of lamivudine to treat acute hepatitis B. Hepatology 2007; 45: 97–101.
- Yu JW, Sun LJ, Zhao YH, Kang P, Li SC. The study of efficacy of lamivudine in patients with severe acute hepatitis B. Dig Dis Sci 2010; 55: 775–783.
- Dao DY, Seremba E, Ajmera V, et al. Use of nucleoside (tide) analogues in patients with hepatitis B-related acute liver failure. Dig Dis Sci 2012; 57: 1349–1357.
- Tassopoulos NC, Koutelou MG, Polychronaki H, Paraloglou-Ioannides M, Hadziyannis SJ. Recombinant interferon-alpha therapy for acute hepatitis B: a randomized, double-blind, placebo-controlled trial. J Viral Hepat 1997; 4: 387–394.
- Tillmann HL, Hadem J, Leifeld L, et al. Safety and efficacy of lamivudine in patients with severe acute or fulminant hepatitis B, a multicenter experience. J Viral Hepat 2006; 13: 256–263.
- Miyake Y, Iwasaki Y, Takaki A, et al. Lamivudine treatment improves the prognosis of fulminant hepatitis B. Intern Med. 2008; 47: 1293–1299.
- Yu JW, Sun LJ, Yan BZ, Kang P, Zhao YH. Lamivudine treatment is associated with improved survival in fulminant hepatitis B. Liver Int 2011; 31: 499–506.
- European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: management of chronic hepatitis B virus infection. J Hepatol 2012; 57: 167–185.
- Gerlich WH, Uy A, Lambrecht F, Thomssen R. Cutoff levels of immunoglobulin M antibody against viral core antigen for differentiation of acute, chronic, and past hepatitis B virus infections. J Clin Microbiol 1986; 24: 288–293.
- Sarin SK, Kumar A, Almeida JA, et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL). Hepatol Int 2009; 3: 269–282.
- Jalan R, Gines P, Olson JC, et al. Acute-on chronic liver failure. J Hepatol 2012; 57: 1336–1348.
- Garg H, Sarin SK, Kumar M, Garg V, Sharma BC, Kumar A. Tenofovir improves the outcome in patients with spontaneous reactivation of hepatitis B presenting as acute-on-chronic liver failure. Hepatology 2011; 53: 774–780.
- Wiese M, Berr F, Lafrenz M, Porst H, Oesen U. Low frequency of cirrhosis in a hepatitis C (genotype 1b) single-source outbreak in Germany: a 20-year multicenter study. Hepatology 2000; 32: 91–96.
- Kato T, Furusaka A, Miyamoto M, et al. Sequence analysis of hepatitis C virus isolated from a fulminant hepatitis patient. J Med Virol 2001; 64: 334–339.
-
EASL. EASL Clinical
Practice Guidelines: management of hepatitis C virus infection.
J Hepatol
2011;
55:
245–264.
10.1016/j.jhep.2011.02.023 Google Scholar
- Ghany MG, Strader DB, Thomas DL, Seeff LB, AASLD. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology 2009; 49: 1335–1374.
- Licata A, Di Bona D, Schepis F, Shahied L, Craxí A, Cammà C. When and how to treat acute hepatitis C? J Hepatol 2003; 39: 1056–1062.
- Corey KE, Mendez-Navarro J, Gorospe EC, Zheng H, Chung RT. Early treatment improves outcomes in acute hepatitis C virus infection: a meta-analysis. J Viral Hepat 2010; 17: 201–207.
- Omata M, Yokosuka O, Takano S, et al. Resolution of acute hepatitis C after therapy with natural beta interferon. Lancet 1991; 338: 914–915.
- Calleri G, Colombatto P, Gozzelino M, et al. Natural beta interferon in acute type-C hepatitis patients: a randomized controlled trial. Ital J Gastroenterol Hepatol 1998; 30: 181–184.
- Viladomiu L, Genescà J, Esteban JI, et al. Interferon-alpha in acute posttransfusion hepatitis C: a randomized, controlled trial. Hepatology 1992; 15: 767–769.
- Tassopoulos NC, Koutelou MG, Papatheodoridis G, et al. Recombinant human interferon alfa-2b treatment for acute non-A, non-B hepatitis. Gut 1993; 34: S130–S132.
- Lampertico P, Rumi M, Romeo R, et al. A multicenter randomized controlled trial of recombinant interferon-alpha 2b in patients with acute transfusion-associated hepatitis C. Hepatology 1994; 19: 19–22.
- Li XW. [ A report on therapy of interferon-A2b in patients with acute hepatitis C] (English abstract). Zhonghua Nei Ke Za Zhi 1993; 32: 409–411.
- Nomura H, Sou S, Tanimoto H, et al. Short-term interferon-alfa therapy for acute hepatitis C: a randomized controlled trial. Hepatology 2004; 39: 1213–1219.
- Hwang SJ, Lee SD, Chan CY, Lu RH, Lo KJ. A randomized controlled trial of recombinant interferon alpha-2b in the treatment of Chinese patients with acute post-transfusion hepatitis C. J Hepatol 1994; 21: 831–836.
- Tillmann HL. Acute HCV: will IL28B testing change the paradigm? Curr Hepat Reports 2012; 10–14.
- Buti M, Homs M, Rodriguez-Frias F, et al. Clinical outcome of acute and chronic hepatitis delta over time: a long-term follow-up study. J Viral Hepat 2011; 18: 434–442.
- Hughes SA, Wedemeyer H, Harrison PM. Hepatitis delta virus. Lancet 2011; 378: 73–85.
- Mele A, Mariano A, Tosti ME, et al. Acute hepatitis delta virus infection in Italy: incidence and risk factors after the introduction of the universal anti-hepatitis B vaccination campaign. Clin Infect Dis 2007; 44: e17–e24.
- Wedemeyer H, Yurdaydìn C, Dalekos GN, et al. Peginterferon plus adefovir versus either drug alone for hepatitis delta. N Engl J Med 2011; 364: 322–331.
- Reyes GR, Purdy MA, Kim JP, et al. Isolation of a cDNA from the virus responsible for enterically transmitted non-A, non-B hepatitis. Science 1990; 247: 1335–1339.
-
Jones TZ,
Farmer AD,
Bosanko N,
Bohan A,
Sen S,
Brind AM.
A rare but important cause of fulminant hepatic failure.
JRSM Short Rep
2011;
2:
61.
10.1258/shorts.2011.011021 Google Scholar
- Aggarwal R. Clinical presentation of hepatitis E. Virus Res 2011; 161: 15–22.
- Bhatia V, Singhal A, Panda SK, Acharya SK. A 20-year single-center experience with acute liver failure during pregnancy: is the prognosis really worse? Hepatology 2008; 48: 1577–1585.
- Kar P, Jilani N, Husain SA, et al. Does hepatitis E viral load and genotypes influence the final outcome of acute liver failure during pregnancy? Am J Gastroenterol 2008; 103: 2495–2501.
- Bose PD, Das BC, Kumar A, Gondal R, Kumar D, Kar P. High viral load and deregulation of the progesterone receptor signaling pathway: association with hepatitis E-related poor pregnancy outcome. J Hepatol 2011; 54: 1107–1113.
- Dalton HR, Fellows HJ, Stableforth W, et al. The role of hepatitis E virus testing in drug-induced liver injury. Aliment Pharmacol Ther 2007; 26: 1429–1435.
- Davern TJ, Chalasani N, Fontana RJ, et al. Acute hepatitis E infection accounts for some cases of suspected drug-induced liver injury. Gastroenterology 2011; 141: 1665–1672.
- Shrestha MP, Scott RM, Joshi DM, et al. Safety and efficacy of recombinant hepatitis E virus vaccine. New Engl J Med 2007; 356: 895–903.
- Zhu FC, Zhang J, Zhang XF, et al. Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults: a large scale, randomized, double blind placebo-controlled, phase 3 trial. Lancet 2010; 376: 895–902.
- Gerolami R, Borentain P, Raissouni F, Motte A, Solas C, Colson P. Treatment of severe acute hepatitis E by ribavirin. J Clin Virol 2011; 52: 60–62.
- Tillmann HL. Non-A-E hepatitis, does it exist, its treatment and proposed pathogenesis and the viruses identified on its discovery route. In: ME Gershwin, JM Vierling, MP Manns, editors. Liver Immunology. Philadelphia: Hanley & Belfus, 2002; pp. 249–262.
- O’Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 1989; 97: 439–445.
- Bernuau J, Samuel D, Durand F, et al. Criteria for emergency liver transplantation in patients with acute viral hepatitis and factor V below 50% of normal: a prospective study. Hepatology 1991; 14: 49A.
- Hadem J, Stiefel P, Bahr MJ, et al. Prognostic implications of lactate, bilirubin, and etiology in German patients with acute liver failure. Clin Gastroenterol Hepatol 2008; 6: 339–345.
- Lee WM, Hynan LS, Rossaro L, et al. Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure. Gastroenterology 2009; 137: 856–864.
- Acharya SK, Bhatia V, Sreenivas V, Khanal S, Panda SK. Efficacy of L-ornithine L-aspartate in acute liver failure: a double-blind, randomized, placebo-controlled study. Gastroenterology 2009; 136: 2159–2168.
- Lidofsky SD, Bass NM, Prager MC, et al. Intracranial pressure monitoring and liver transplantation for fulminant hepatic failure. Hepatology 1992; 16: 1–7.
- White H, Baker A. Continuous jugular venous oximetry in the neurointensive care unit – a brief review. Can J Anaesth 2002; 49: 623–629.
-
Simpson E,
Lin Y,
Stanworth S,
Birchall J,
Doree C,
Hyde C.
Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia (review).
Cochrane Database Syst Rev
2012;3:CD005011.
10.1002/14651858.CD005011.pub4 Google Scholar
- Ekser B, Ezzelarab M, Hara H, et al. Clinical xenotransplantation: the next medical revolution? Lancet 2012; 379: 672–683.
- Pascher A, Sauer IM, Hammer C, Gerlach JC, Neuhaus P. Extracorporeal liver perfusion as hepatic assist in acute liver failure: a review of world experience. Xenotransplantation 2002; 9: 309–324.
- Jain A, Reyes J, Kashyap R, et al. Long-term survival after liver transplantation in 4,000 consecutive patients at a single center. Ann Surg. 2000; 232: 490–500.
- http://www.ustransplant.org/annual_reports/current/912a_rec-dgn_li.htm accessed 04.15. 2013
