Letters To The Editor
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2015; 21(36): 10485-10486
Published online Sep 28, 2015. doi: 10.3748/wjg.v21.i36.10485
Corticosteroid and nucleoside analogue for hepatitis B virus-related acute liver failure
Keiichi Fujiwara, Shin Yasui, Osamu Yokosuka
Keiichi Fujiwara, Shin Yasui, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Author contributions: Fujiwara K and Yokosuka O designed research; Fujiwara K and Yasui S performed research; Fujiwara K and Yasui S analyzed data; Fujiwara K wrote the letter; and Fujiwara K revised the letter.
Conflict-of-interest statement: Osamu Yokosuka has received research funding from Chugai Pharma.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Keiichi Fujiwara, MD, PhD, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Chiba, Japan. fujiwara-cib@umin.ac.jp
Telephone: +81-43-2262083 Fax: +81-43-2262088
Received: March 10, 2015
Peer-review started: March 11, 2015
First decision: April 13, 2015
Revised: April 16, 2015
Accepted: June 10, 2015
Article in press: June 10, 2015
Published online: September 28, 2015
Processing time: 201 Days and 19.4 Hours
Core Tip

Core tip: Nucleoside analogues generally need some weeks before hepatitis B virus DNA becomes undetectable and therefore they may be too slow to influence the clinical course of acute severe liver failure, and the overwhelming anti-viral immune response might actively contribute to the effectiveness of treatment. We have performed prospective study of early introduction of high-dose corticosteroid with/without nucleoside analogue for severe acute reactivation of chronic hepatitis B since 1997, and recovery rate without liver transplantation improved from 25% to 70%.