| [ Summary ] |
There are two kinds of fulminant hepatitis (FH) B in Japan and other Asian countries. One, common to western countries, is FH-B, caused by acute infection with hepatitis B virus (HBV). The other is FH-B, occurring during chronic HBV infection. The former is more likely to be of the "acute type" according to the Japanese diagnostic criteria proposed at the Inuyama Symposium. The latter is more often to be of the form of the "subacute type". The prognosis of FE-B, due to acute infection, is generally favorable when patients are kept alive by intensive liver support such as the one we originated. This is true except for the "hyperacute type", in which the whole liver is almost instantaneously destroyed at the onset of the disease. Accordingly, the "hyperacute type" is an absolute indicator of the need for liver transplantation. The prognosis for FH-B during chronic infection is generally less favorable, unless both persistent HBV replication and enhanced host immune reactions are effectively suppressed by the combination of antiviral and immunosuppressive treatments. If the start of treatment is delayed, patients are subjected to liver transplantation which is difficult for these patients in reality. |