Efficacy of Lamivudine therapy on decompensated liver cirrhosis due to chronic hepatitis B

The aim of this study was to determine the effect of lamivudine on liver function and clinical status of the patients with decompensated cirrhosis arising from hepatitis B virus [HBV]. In a clinical trial on the basis of liver consideration in 55 patients with cirrhosis that had positive HBsAg and HBV DNA, Child-Pugh score more than 8 and some other criteria were treated with lamivudine. In these patients, serum level of bilirubin, albumin, ALT, AST and also the PT-INR were controlled at the beginning of study and then at intervals of 2 to 6 months and finally 12 months after the start of treatment. Five patients died in the first 6 months of treatments. The following results are related to 50 patients being under treatment with lamivudine at least for a period of 6 months. In these patients mean Child-Pugh score was decreased from 11 +/- 2 to 7 +/- 1 [P < 0.0001]. All of the patients tolerated this drug very well. Lamivudine can be effective in improvement of liver function in patients with decompensated liver cirrhosis resulting from HBV, but for determination of proper period of treatment, further studies are necessary

effects of liver dysfunction on serum lipoprotein levels in patients with cirrhosis and chronic hepatitis

The liver plays a main role in the production and metabolism of lipoproteins, and then impaired lipid metabolism is often seen in patients with liver cirrhosis and chronic hepatitis [CH]. As a result, plasma lipid levels could be as useful indicators of liver function and patient's prognosis especially in liver cirrhosis. We measured the lipoprotein levels in 77 consecutive patients with liver cirrhosis and CH. 47 men [61%] and 30 women [39%] with mean age 43years [SD=16.4] and mean BMI 26[SD=4.2] have been recruited as patients group. Child score and MELD scale was determined in patients group. The control group was age and sex matched with patients group. In case group, the levels of HDL LDL, TG, and total cholesterol were significantly lower than control group [p <0.0001]. In patients with cirrhosis, the levels of LDL, HDL and total cholesterol were progressively lower when comparing patients in Child class A with patients in class C [p<0.0001].This difference was more significant in LDL and total cholesterol and between upper Child scores similarly decreasing in LDL, HDL, and total cholesterol level was observed when MELD score increased [P<0.0001]. There is a correlation between plasma lipid levels and liver function, so it may be mentioned as an accessible and reliable indicator of liver function in cirrhotic and CH patients