Hope-For-HepB Top10 January 2008

Telbivudine versus lamivudine in patients with chronic hepatitis B.

Lai CL, Gane E, Liaw YF, Hsu CW, Thongsawat S, Wang Y, Chen Y, Heathcote EJ, Rasenack J, Bzowej N, Naoumov NV, Di Bisceglie AM, Zeuzem S, Moon YM, Goodman Z, Chao G, Constance BF, Brown NA.

N Engl J Med. 2007;357(25):2576-88.

Rating & Commentary
** First large randomised study in 1,370 patients with HBeAg positive or HBeAg negative chronic hepatitis B showing that telbivudine results in more profound viral suppression compared to lamivudine. Rates of antiviral resistance were lower for telbivudine, but still significant.

Symptomatology and health attitudes of chronic hepatitis B patients in the USA.

Hann HW, Han SH, Block TM, Harris M, Maa JF, Fisher RT, Atillasoy E.

J Viral Hepat. 2008;15(1):42-51.

Rating & Commentary
** Large study in 258 chronic hepatitis B infected persons confirming that the majority of patients had complaints of fatigue (90%) and loss of appetite (79%). Asians appeared more accepting and less concerned about the disease compared to non-Asians.

Longitudinal changes in serum HBV DNA levels and predictors of progression during the natural course of HBeAg-negative chronic hepatitis B virus infection.

Papatheodoridis GV, Chrysanthos N, Hadziyannis E, Cholongitas E, Manesis EK.

J Viral Hepat. 2008 Jan 9; [Epub ahead of print].

Rating & Commentary
* Large prospective study in 150 untreated HBeAg negative chronic hepatitis B patients confirming that virtually inactive carriers had HBV DNA <20,000 IU/ml. Patients with higher baseline ALT levels and serum HBV DNA of 2,000-5,000 IU/ml had in increased risk of progression to chronic hepatitis.

Mortality related to chronic hepatitis B and chronic hepatitis C in France: Evidence for the role of HIV coinfection and alcohol consumption.

Marcellin P, Pequignot F, Delarocque-Astagneau E, Zarski JP, Ganne N, Hillon P, Antona D, Bovet M, Mechain M, Asselah T, Desenclos JC, Jougla E.

J Hepatol. 2008;48(2):200-207.

Rating & Commentary
* Study on death certificates in France showing an estimated 4.5 and 2.2 deaths per 100,000 inhabitants due to hepatitis C virus (HCV) and hepatitis B virus (HBV) infection, respectively. Virtually all of these patients had cirrhosis. Alcohol abuse and HIV coinfection were important co-factors.

The Impact of Chronic Hepatitis B on Quality of Life: A Multinational Study of Utilities from Infected and Uninfected Persons.

Levy AR, Kowdley KV, Iloeje U, Tafesse E, Mukherjee J, Gish R, Bzowej N, Briggs AH.

Value Health. 2007 Dec 17; [Epub ahead of print].

Rating & Commentary
* Large study in 534 chronic hepatitis B infected patients and 600 uninfected controls confirming that chronic hepatitis and cirrhosis had moderate impact on health-related quality of life (HRQOL), while decompensated cirrhosis and HCC had stronger impact. Futhermore, significant intercountry differences were seen.

Hepatitis B virus DNA levels at week 4 of lamivudine treatment predict the 5-year ideal response.

Yuen MF, Fong DY, Wong DK, Yuen JC, Fung J, Lai CL.

Hepatology. 2007;46(6):1695-703.

Rating & Commentary
* Detailed long-term follow-up study in 74 lamivudine treated hepatitis B e antigen (HBeAg)-positive.chronic HBV patients showing that 23% achieved optimal response at year 5 (HBV DNA < 2000 copies/ml, HBeAg seroconversion, normal ALT and absence YMDD mutations). HBV DNA <10e4 copies/ml at week 4 was found to be a very good predictor of long-term response (AUC 0.89).

Chronic hepatitis B in Italy: new features of an old disease--approaching the universal prevalence of hepatitis B e antigen-negative cases and the eradication of hepatitis D infection.

Sagnelli E, Stroffolini T, Mele A, Imparato M, Almasio PL.

Clin Infect Dis. 2008;46(1):110-3.

Rating & Commentary
* Large study in 1336 consecutive hepatitis B infected persons in Italy confirming that HBeAg negative disease is most prevalent in this area (86%). Older age (>49 years), alcohol abuse, and anti-HDV and anti-HCV positivity were independent predictors of liver cirrhosis.

Hepatitis B seroprevalence and anamnestic response amongst Taiwanese young adults with full vaccination in infancy, 20 years subsequent to national hepatitis B vaccination.

Su FH, Cheng SH, Li CY, Chen JD, Hsiao CY, Chien CC, Yang YC, Hung HH, Chu FY.

Vaccine. 2007;25(47):8085-90. Epub 2007 Sep 21.

Rating & Commentary
* Large vaccination study in 843 young adults who completed HBV vaccination during infancy confirming that the prevalence of HBsAg positivity is low (1.4%) and most respond well to booster vaccination.

Switching patients with lamivudine resistant chronic hepatitis B virus from tenofovir to adefovir results in less potent HBV-DNA suppression.

Leemans WF, Janssen HL, Niesters HG, de Man RA.

J Viral Hepat. 2008;15(2):108-14.

Rating & Commentary
* Small study in 10 HBV infected patients who were switched to adefovir monotherapy after receiving tenofovir add-on because of lamivudine resistance. Six patients had an increase in HBV DNA after starting adefovir, which declined after restarting tenofovir, suggesting stronger antiviral potency of tenofovir.

Exacerbation of chronic hepatitis B infection after delivery.

Ter Borg MJ, Leemans WF, de Man RA, Janssen HL.

J Viral Hepat. 2008 Jan;15(1):37-41.

Rating & Commentary
*.Small cohort study in 31 chronic hepatitis B infected pregnant women showing that 45% had an exacerbation of hepatic inflammation after delivery, with ALT levels up to 4 x ULN. Close monitoring of women after delivery is therefore recommended.