Đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị đợt bùng phát viêm gan vi rút B tại khoa Bệnh nhiệt đới & can thiệp giảm hại, Bệnh viện Đại học Y Hà Nội

Abstract

Severe acute flares of hepatitis B virus may progress to acute liver failure or acute-on-chronic liver failure (ACLF), leading to an increased risk of mortality. A study was conducted on 50 patients hospitalized for hepatitis B flares at the Department of Infectious Diseases and Harm Reduction, Hanoi Medical University Hospital; the mean age was 44.3 ± 11.4 years old, with a predominance of male patients (84%). Eighteen patients (36%) were newly diagnosed with hepatitis B virus infection, while 14 patients (43.75%) had previously received nucleos(t)ide analogue therapy but discontinued treatment without medical supervision. Fatigue and anorexia were the most common presenting symptoms, reported in 92% and 82% of patients, respectively. The median serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels at admission were 641 U/L and 960 U/L, respectively. Baseline total bilirubin levels and the degree of GPT reduction after one week of treatment were associated with the length of hospitalization. Most patients achieved favorable clinical outcomes, with 44 patients (88%) discharged with clinical improvement; however, six patients (12%) deteriorated during hospitalization and were referred to tertiary centers, including two patients who required plasma exchange.