Evaluation of the therapeutic efficacy of lamivudine combined with plasma exchange for treating acute-on-chronic hepatitis B liver failure

ObjectiveTo observe the clinical effects of lamivudine antiviral therapy combined with plasma exchange in patients with acute-on-chronic hepatitis B liver failure. MethodsForty-seven patients (treatment group) were administered lamivudine and underwent plasma exchange. An additional forty-five patients (control group) were administered lamivudine but no plasma exchange. Otherwise, all patients received the same basic medical treatment. The two groups were further divided into three sub-groups according to the model for end-stage liver disease (MELD) score: ＜30, 30-39, and ≥40. The significance of differences in survival rates between the groups and sub-groups was determined by the χ2 test. ResultsThe overall survival rate was significantly better in the treatment group (63.82% vs. control group: 44.44%; χ2=4.31, P＜0.05). Within the treatment group, the survival rates were highest in the 30-39 MELD score sub-group (71.42%), which was significantly different from survival rate in the same sub-group of the controls (vs. 38.10%; χ2=4.71, P＜005). The other two MELD score sub-groups showed no significant differences between the treatment and control groups (all P＞0.05). ConclusionCombined therapy consisting of lamivudine treatment and plasma exchange can improve the survival rate of patients with acute-on-chronic hepatitis B liver failure who have MELD scores between 30 and 39.