Year 2013 / Volume 105 / Number 1
Letter to the Editor
Tenofovir treatment of the severe acute hepatitis B

pp. 59-61

Fernando Casals-Seoane, Beatriz Arberas-Díez y Luisa García-Buey

Abstract
A fifty-five-year-old male, with no medical history, seeks med- ical consultation after five days of asthenia, hyporexia, jaundice of the skin and eyes, choleretic urine and hypocolic stools. In the urgent analysis, there is a strong presence of cytolisis (AST 1720 UI/dL, ALT 2660 UI/dL), hyperbilirubinemia (total bilirubin 20.94 mg/dL) and coagulopathy (prothrombin activity, 45%; INR, 1.79). HBV serologies turned out to be positive (HBsAg +, anti- HBc IgM + and AgHBe +). The serologies of the HCV, HDV and HIV turned out to be negative.
In the presence of severe acute liver failure, it is decided to use a specific treatment for the acute hepatitis B with tenofovir 245 mg/24 hours from the first day of the hospital admission.
The patient remained hospitalized for a period of 14 days, without having hepatic encephalopathy or any external signs of bleeding at any moment. The analytical figures started to improve from the day number 7 of the antiviral treatment. Sub- sequently, the patient continued the treatment with tenofovir as an outpatient, the anti-HBe seroconversion occurred one month after the treatment was started and the HBsAg loss 8 weeks after the treatment was started. After two consecutive serologies HBsAg negative and anti-HBs positive, the antiviral treatment was suspended.
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Fernando Casals-Seoane, Beatriz Arberas-Díez y Luisa García-Buey. Tenofovir treatment of the severe acute hepatitis B. 59-61


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