Prohibition Of Lamivudine

(1) Chronic asymptomatic hepatitis B virus carriers with normal transaminase and no symptoms should not take lamivudine, regardless of whether there are virus replication indicators (whether "big three positive" or "small three positive"). However, it is understood that the phenomenon of taking this drug is quite common among these people at present, which wastes drugs and money. At present, the treatment of hepatitis B virus carriers has not been solved, and medical experts are also studying and exploring, and the existing methods are immature. The important reason why lamivudine cannot be used to treat patients with hepatitis B virus is that it is ineffective. After someone takes it, HBV DNA may fall below 103 copies/ml, and it will rebound immediately once the drug is stopped. We found that some people took HBeAg for more than one and a half years, and HBV DNA turned negative, but rebounded less than one month after stopping the drug, and HBeAg could not turn negative at all. Therefore, this drug can no longer be used to treat patients with hepatitis B virus. It can only be considered for use when the pathological changes of chronic hepatitis are confirmed by liver biopsy.
(2) Acute severe hepatitis or acute liver failure, which is in a critical condition and comes in a fierce manner, is not the main chemicalbook contradiction of the patient at this time. Some patients even have no virus replication index. What threatens the life of the patient is liver failure. According to the principle of "treating the root of the disease slowly, and treating the target of the disease urgently", the most important thing at this time is supportive therapy, such as injecting fresh plasma, albumin, artificial liver support therapy, etc.
(3) In the acute attack of chronic hepatitis B, if the transaminase is more than 10 times of the upper limit of the normal value, there is obvious jaundice, or the serum bilirubin is more than 85.5 mmol/L, it is not suitable to take lamivudine and other antiviral drugs for the time being, but mainly to protect the liver, reduce jaundice, and reduce enzymes, which can be used in a small amount when the disease is relieved. Although lamivudine does not have a strong impact on immune function like interferon, it is not the best policy to prevent immune damage during acute hepatitis attack.
(4) For chronic hepatitis B pregnancy or hepatitis B infection after pregnancy, do not use this product. The main reason is that the effect of lamivudine on the fetus has not been clarified. Although there are application reports both at home and abroad, which are relatively safe, our experts have not reached a consensus. For the sake of caution, it is a wise choice not to apply them temporarily.