{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T10:14:50Z","timestamp":1772187290614,"version":"3.50.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2013,6,11]],"date-time":"2013-06-11T00:00:00Z","timestamp":1370908800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0065952","type":"journal-article","created":{"date-parts":[[2013,6,11]],"date-time":"2013-06-11T17:11:31Z","timestamp":1370970691000},"page":"e65952","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["The Efficacy and Safety of Nucleos(t)ide Analogues in Patients with Spontaneous Acute Exacerbation of Chronic Hepatitis B: A Systematic Review and Meta-Analysis"],"prefix":"10.1371","volume":"8","author":[{"given":"Weiyan","family":"Yu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caiyan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yadong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongzhi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2013,6,11]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1002\/hep.23190","article-title":"Chronic hepatitis B: update 2009","volume":"50","author":"AS Lok","year":"2009","journal-title":"Hepatology"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.jhep.2012.02.010","article-title":"EASL clinical practice guidelines: Management of chronic hepatitis B virus infection","volume":"57","journal-title":"J Hepatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1055\/s-2008-1040788","article-title":"Evolving concepts of the clinical and serologic consequences of hepatitis B virus infection","volume":"6","author":"LB Seeff","year":"1986","journal-title":"Semin Liver Dis"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/0168-8278(90)90069-4","article-title":"Acute exacerbations in Chinese patients with chronic hepatitis B virus (HBV) infection. Incidence, predisposing factors and etiology","volume":"10","author":"AS Lok","year":"1990","journal-title":"J Hepatol"},{"key":"ref5","first-page":"1650","article-title":"A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B. World J Gastroenterol","volume":"15","author":"K Matsumoto","year":"2009"},{"key":"ref6","first-page":"322","article-title":"The effect of lamivudine therapy in hepatic decompensation during acute exacerbation of chronic hepatitis B. J Hepatol","volume":"38","author":"RN Chien","year":"2003"},{"key":"ref7","first-page":"426","article-title":"Lamivudine monotherapy for spontaneous severe acute exacerbation of chronic hepatitis B. J Gastroenterol Hepatol","volume":"20","author":"A Tsubota","year":"2005"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1111\/j.1572-0241.2001.03559.x","article-title":"Lamivudine therapy for spontaneously occurring severe acute exacerbation in chronic hepatitis B virus infection: a preliminary study","volume":"96","author":"A Tsubota","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"4095","DOI":"10.3748\/wjg.v16.i32.4095","article-title":"Efficacy of telbivudine in HBeAg-positive chronic hepatitis B patients with high baseline ALT levels","volume":"16","author":"GC Lv","year":"2010","journal-title":"World J Gastroenterol"},{"key":"ref10","first-page":"236","article-title":"Entecavir treatment in patients with severe acute exacerbation of chronic hepatitis B. J Hepatol","volume":"54","author":"VW Wong","year":"2011"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1007\/s12072-010-9227-x","article-title":"Predictors for early HBeAg loss during lamivudine therapy in HBeAg-positive chronic hepatitis B patients with acute exacerbation","volume":"5","author":"CY Peng","year":"2011","journal-title":"Hepatol Int"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1002\/hep.510300313","article-title":"Pretherapy alanine transaminase level as a determinant for hepatitis B e antigen seroconversion during lamivudine therapy in patients with chronic hepatitis B. Asian Hepatitis Lamivudine Trial Group","volume":"30","author":"RN Chien","year":"1999","journal-title":"Hepatology"},{"key":"ref13","first-page":"571","article-title":"Long-term follow-up of lamivudine treatment in patients with severe acute exacerbation of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. Antivir Ther","volume":"13","author":"VW Wong","year":"2008"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/MEG.0b013e3283131389","article-title":"Lamivudine monotherapy for chronic hepatitis B infection with acute exacerbation revisited","volume":"21","author":"MJ Sheu","year":"2009","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/S0168-8278(02)00267-2","article-title":"Durability of lamivudine-induced HBeAg seroconversion for chronic hepatitis B patients with acute exacerbation","volume":"37","author":"CM Lee","year":"2002","journal-title":"J Hepatol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S0168-8278(02)00335-5","article-title":"Long-term prognosis by lamivudine monotherapy for severe acute exacerbation in chronic hepatitis B infection: emergence of YMDD motif mutant and risk of breakthrough hepatitis \u2013 an open-cohort study","volume":"38","author":"N Akuta","year":"2003","journal-title":"J Hepatol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1046\/j.1365-2893.2002.00385.x","article-title":"The role of lamivudine and predictors of mortality in severe flare-up of chronic hepatitis B with jaundice","volume":"9","author":"HL Chan","year":"2002","journal-title":"J Viral Hepat"},{"key":"ref18","first-page":"465","article-title":"Long-term lamivudine treatment is associated with a good maintained response in severe acute exacerbation of chronic HBeAg-negative hepatitis B. Antivir Ther","volume":"11","author":"HL Chan","year":"2006"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1365-2036.2006.02718.x","article-title":"Poor response to 18-month lamivudine monotherapy in chronic hepatitis B patients with IgM anti-HBc and acute exacerbation","volume":"23","author":"JJ Chen","year":"2006","journal-title":"Aliment Pharmacol Ther"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1111\/j.1478-3231.2008.01766.x","article-title":"A higher alanine aminotransferase level correlates with earlier hepatitis B e antigen seroconversion in lamivudine-treated chronic hepatitis B patients","volume":"28","author":"TC Tseng","year":"2008","journal-title":"Liver Int"},{"key":"ref21","first-page":"27","article-title":"Efficacy of lamivudine or entecavir on acute exacerbation of chronic hepatitis B. Int J Med Sci","volume":"9","author":"T Kanda","year":"2012"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Liaw YF, Kao JH, Piratvisuth Ta, Chan HY, Chien RN, <etal>et al<\/etal>.. (2012) Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int 2012. <comment>DOI <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/dx.doi.org\/10.1007\/s12072-012-9365-4\" xlink:type=\"simple\">10.1007\/s12072-012-9365-4<\/ext-link><\/comment>","DOI":"10.1007\/s12072-012-9365-4"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1111\/j.1440-1746.2009.05924.x","article-title":"Severe acute exacerbation of chronic hepatitis B: a unique presentation of a common disease","volume":"24","author":"VW Wong","year":"2009","journal-title":"J Gastroenterol Hepatol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1046\/j.1365-2036.2001.01107.x","article-title":"Lamivudine treatment for fulminant hepatic failure due to acute exacerbation of chronic hepatitis B infection","volume":"15","author":"SW Tsang","year":"2001","journal-title":"Aliment Pharmacol Ther"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/0016-5085(85)90566-9","article-title":"Hepatic decompensation associated with hepatitis B e antigen clearance in chronic type B hepatitis","volume":"89","author":"IS Sheen","year":"1985","journal-title":"Gastroenterology"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/j.1600-0676.1990.tb00455.x","article-title":"Acute exacerbation in patients with liver cirrhosis: a clinicopathological study","volume":"10","author":"YF Liaw","year":"1990","journal-title":"Liver"},{"key":"ref27","first-page":"1109","article-title":"Importance of adequate immunosuppressive therapy for the recovery of patients with \u201clife-threatening\u201d","volume":"11","author":"K Fujiwara","year":"2005","journal-title":"severe exacerbation of chronic hepatitis B. World J Gastroenterol"},{"key":"ref28","first-page":"711","article-title":"Efficacy of combination therapy of antiviral and immunosuppressive drugs for the treatment of severe acute exacerbation of chronic hepatitis B. J Gastroenterol","volume":"43","author":"K Fujiwara","year":"2008"},{"key":"ref29","first-page":"541","article-title":"Hepatitis B virus DNA level predicts hepatic decompensation in patients with acute exacerbation of chronic hepatitis B. Clin Gastroenterol Hepatol","volume":"8","author":"WJ Jeng","year":"2010"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1007\/s00535-012-0561-8","article-title":"Determinants of the clinical outcome of patients with severe acute exacerbation of chronic hepatitis B virus infection","volume":"47","author":"N Mori","year":"2012","journal-title":"J Gastroenterol"},{"key":"ref31","unstructured":"Scaglione SJ, Lok AS (2012) Effectiveness of hepatitis B treatment in clinical practice. Gastroenterology 142: 1360\u20131368 e1361."},{"key":"ref32","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/j.1751-2980.2009.00375.x","article-title":"A 7-year study of lamivudine therapy for hepatitis B virus e antigen-positive chronic hepatitis B patients in China","volume":"10","author":"GB Yao","year":"2009","journal-title":"J Dig Dis"},{"key":"ref33","first-page":"11","article-title":"Baseline characteristics and early on-treatment response predict the outcomes of 2 years of telbivudine treatment of chronic hepatitis B. J Hepatol","volume":"51","author":"S Zeuzem","year":"2009"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1038\/ajg.2011.253","article-title":"Quantitative hepatitis B surface antigen levels in patients with chronic hepatitis B after 2 years of entecavir treatment","volume":"106","author":"J Fung","year":"2011","journal-title":"Am J Gastroenterol"}],"container-title":["PLoS ONE"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pone.0065952","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,10,20]],"date-time":"2018-10-20T01:58:54Z","timestamp":1540000734000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0065952"}},"subtitle":[],"editor":[{"given":"James","family":"Fung","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2013,6,11]]},"references-count":34,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2013,6,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0065952","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718020383.793493889","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,11]]}}}