Hope-For-HepB Top10 August 2009

Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2008 update.

Liaw YF, Leung N, Kao JH, Piratvisuth T, Gane E, Han KH, Guan R, Lau GK, Locarnini S; for the Chronic Hepatitis B Guideline Working Party of the Asian-Pacific Association for the Study of the Liver.

Hepatol Int. 2008 Sep;2(3):263-283. Epub 2008 May 10.

Rating & Commentary
***This update of the Asian-Pacific guideline for management of chronic hepatitis B complements with the American (Ann Int.Med 2009; 150:109-10) and European guidelines (J.Hepatol 2009;50:227-42) to provide global coverage of management of chronic hepatitis B.

Chronic hepatitis B: Update 2009.

Lok AS, McMahon BJ

www.aasld.org / Hepatology. 2009;50(3):661-662.

Rating & Commentary
*** Recent update of AASLD Practice guideline (www.aasld.org) with focus on the added value of tenofovir and expansion of HBV screening, particularly in those receiving cancer chemotherapy or long-term immunosuppressive therapy, and in persons born in intermediate endemic countries.

Prediction of the prognosis of patients with acute-on-chronic hepatitis B liver failure using the model for end-stage liver disease scoring system and a novel logistic regression model.

Sun QF, Ding JG, Xu DZ, Chen YP, Hong L, Ye ZY, Zheng MH, Fu RQ, Wu JG, Du QW, Chen W, Wang XF, Sheng JF.

J Viral Hepat. 2009 Jul;16(7):464-70. Epub 2009 Apr 29.

Rating & Commentary
* This study of patients with acute-on-chronic hepatitis B highlights the grave prognosis. MELD-score is predictive, but the accuracy is not impressive; other factors related to the cause of the acute flare and to the stage of the liver disease should also be included in prognostic assessment.

Reactivation of Hepatitis B with Reappearance of Hepatitis B Surface Antigen After Chemotherapy and Immune Suppression.

Palmore TN, Shah NL, Loomba R, Borg BB, Lopatin U, Feld JJ, Khokhar F, Lutchman G, Kleiner DE, Young NS, Childs R, Barrett AJ, Liang TJ, Hoofnagle JH, Heller T.

Clin Gastroenterol Hepatol. 2009 Oct;7(10):1130-7. Epub 2009 Jul 1

Rating & Commentary
* Case series of 6 HBsAg-negative patients developed reappearance of HBsAg and evidence of active liver disease and virus transmission in 2 after stem cell transplantation (n=4), immunosuppressive therapy (n=1) or change in HIV anti-retroviral regimen (n=1) despite having antibody to HBsAg (anti-HBs) or antibody to hepatitis B core antigen (anti-HBc).

Combination of baseline parameters and on-treatment hepatitis B virus DNA levels to start and continue patients with lamivudine therapy.

Yuen MF, Fung J, Seto WK, Wong DK, Yuen JC, Lai CL.

Antivir Ther. 2009;14:679-85.

Rating & Commentary
* This cohort study in 74 HBeAg positive patients indicates that for those with HBV DNA <9 log(10) copies per ml and ALT >/=2x ULN lamivudine is still an excellent therapy particularly if HBV DNA is < 3 log(10) at week 24.

High rates of HBsAg seroconversion in HBeAg-positive chronic hepatitis B patients responding to interferon: a long-term follow-up study.

Moucari R, Korevaar A, Lada O, Martinot-Peignoux M, Boyer N, Mackiewicz V, Dauvergne A, Cardoso AC, Asselah T, Nicolas-Chanoine MH, Vidaud M, Valla D, Bedossa P, Marcellin P.

J Hepatol. 2009 Jun;50(6):1084-92. Epub 2009 Mar 9.

Rating & Commentary
* Cohort study in HBeAg-positive patients that confirms the high HBsAg seroconversion rate in those treated with interferon and responding with HBeAg seroconversion and undetectable HBV DNA 1 year after therapy.

Baseline characteristics and early on-treatment response predict the outcomes of 2 years of telbivudine treatment of chronic hepatitis B.

Zeuzem S, Gane E, Liaw YF, Lim SG, DiBisceglie A, Buti M, Chutaputti A, Rasenack J, Hou J, O'Brien C, Nguyen TT, Jia J, Poynard T, Belanger B, Bao W, Naoumov NV.

J Hepatol. 2009 Jul;51(1):11-20. Epub 2009 Feb 12.

Rating & Commentary
* Large pivotal study on telbivudine in chronic hepatitis B, indicating that HBV DNA at week 24 of therapy is the strongest predictor of outcome at 2 years.

Mitochondrial myopathy caused by clevudine therapy in chronic hepatitis B patients.

Tak WY, Park SY, Jung MK, Jeon SW, Cho CM, Kweon YO, Kim SK, Choi YH.

Hepatol Res. 2009 Sep;39(9):944-7.

Rating & Commentary
* Study confirming myopathy caused by clevudine therapy in chronic hepatic B.

Antiviral therapy reduces portal pressure in patients with cirrhosis due to HBeAg-negative chronic hepatitis B and significant portal hypertension.

Manolakopoulos S, Triantos C, Theodoropoulos J, Vlachogiannakos J, Kougioumtzan A, Papatheodoridis G, Tzourmakliotis D, Karamanolis D, Burroughs AK, Archimandritis A, Raptis S, Avgerinos A.

J Hepatol. 2009 Sep;51(3):468-74. Epub 2009 Jul 3

Rating & Commentary
* Small study evaluating the effect of lamivudine in advanced HBeAg-negative cirrhosis. In patients with virological suppression and biochemical remission the hepatic venous pressure gradient fell during lamivudine therapy.

Factors contributing to antiviral effect of adefovir dipivoxil therapy added to ongoing lamivudine treatment in patients with lamivudine-resistant chronic hepatitis B.

Kurashige N, Hiramatsu N, Ohkawa K, Yakushijin T, Kiso S, Kanto T, Takehara T, Kasahara A, Doi Y, Yamada A, Oshita M, Mita E, Hagiwara H, Nagase T, Yoshihara H, Hayashi E, Imai Y, Kato M, Kashihara T, Hayashi N.

J Gastroenterol. 2009;44(6):601-7. Epub 2009 Apr 22.

Rating & Commentary
* In this relatively large cohort of 75 chronic hepatitis B patients receiving adefovir because of LAM-resistance.