DOI: 10.36347/sasjs.2020.v06i12.001

Pages: 371-379

Background: A virus which primarily causes inflammation of he liver. The hepatitis B virus can be transmitted in several ways including blood transfusion, needle sticks, body piercing and tattooing using unsterile instruments, dialysis, sexual and evenless intimate close contact, and childbirth. Acute on chronic liver failure (ACLF) is an acute hepatic insult manifested as Jaundice and Coagulopathy, complicated within 4 weeks by clinical ascites and/or Encephalopathy in a patient with previously diagnosed or undiagnosed Chronic Liver Disease/Cirrhosis. It is associated with high 28-day mortality rate ranging from 30% to 70%. Reactivation of Hepatitis B virus infection and super infection with hepatitis A or E are the major causes of ACLF in the Asian region. Liver transplantation is the only definitive therapy though it is not available everywhere and not feasible always. Again MARS therapy (Molecular Adsorbent Recirculating System) didn’t reduce mortality significantly. So, antiviral therapy should be started as soon as possible in patients with ACLF due to Hepatitis B irrespective of DNA and ALT status to improve hepatic dysfunction and rescue the patients from mortality. Aims: This randomized clinical trial was carried out with an aimto see survival among patients with acute on chronic hepatitis B liver failure 03 months after the antiviral (Tenofovir or Entecavir) therapy. Methodology: In this study a total of 32 acute on chronic Hepatitis B liver failure patients (age > 18 years with both sexes but male predominant) were included in Hepatology department of Bangabandhu Sheikh Mujib Medical University, Dhaka during January 2013 to December 2015. The patients were randomized into two groups: Tenofovir group (N=16) and Entecavir group (N=16) and followed at least for 03 months. Result: The total study population was 32 Tenofovir and Entecavir ware 15, 13(86.66) tenofovir and entecavir of 7 days. 6(60.00) tenofovir and entecavir of 8-15 days. 1(14.28) tenofovir....