Life-Threatening Complications of Hepatitis B Virus-Related Polyarteritis Nodosa Developing Despite Interferon-[alpha]2b Therapy: Successful Treatment with a Combination of Interferon, Lamivudine, Plasma Exchanges and Steroids

• Published in: Clinical rheumatology Vol. 20; no. 4; p. 290
• Main Authors: Dele´aval, P, Stadler, P, Descombes, E, Hecker, E, Schrago, G, Chizzolini, C, Nicole, A, Pugin, P, Regamey, C
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer Nature B.V 01-07-2001
• Subjects: Drug therapy; Hepatitis; HIV; Human immunodeficiency virus
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s100670170050

Polyarteritis nodosa (PAN) is a rare vasculitis associated with hepatitis B virus (HBV) infection in a significant proportion of cases. When used to treat HBV-related PAN, immunosuppressive agents may enhance viral replication and relaspes are frequent. In recent years the use of antiviral drugs has been proposed. We report the case of a patient with HBV-related PAN who, despite 6 weeks of interferon-α^sub 2b^ (IFN-α^sub 2b^) monotherapy, developed life-threatening complications with bowel perforation. He was thereafter successfully treated with a combination of IFN-α^sub 2b^, lamivudine, plasma exchanges and short-term steroids. In contrast to IFN-α^sub 2b^, lamivudine is effective in rapidly suppressing viral replication. This may be valuable in the treatment of HBV-related PAN by contributing to a faster diminution of circulating immune complex levels. This case report highlights the importance of aggressive combined therapy in patients with HBV-related PAN.[PUBLICATION ABSTRACT]