Hope-For-HepB Top10 January 2009

Evaluation of alanine transaminase and hepatitis B virus DNA to predict liver cirrhosis in hepatitis B e antigen-negative chronic hepatitis B using transient elastography.

Wong GL, Wong VW, Choi PC, Chan AW, Chim AM, Yiu KK, Chan HY, Chan FK, Sung JJ, Chan HL.

Am J Gastroenterol. 2008 Dec;103(12):3071-81.

Rating & Commentary
** Large prospective study in HBeAg-negative chronic hepatitis B. indicating a prevalence of cirrhosis of 11-31% based on liver stiffness measurements. In the subpopulation of patients with low-normal ALT and HBV DNA less than 104 copies, the prevalence of cirrhosis was 3-10%. Liver stiffness in addition to serum ALT and HBV DNA appears of important clinical value for categorizing HBeAg negative chronic hepatitis B.

The role of serial measurement of serum HBV DNA levels in patients with chronic HBeAg(-) hepatitis B infection: association with liver disease progression. A prospective cohort study.

Zacharakis G, Koskinas J, Kotsiou S, Tzara F, Vafeiadis N, Papoutselis M, Maltezos E, Sivridis E, Papoutselis K.

J Hepatol. 2008 Dec;49(6):884-91. Epub 2008 Jul 2.

Rating & Commentary
* Long-term cohort study confirming the clinical value of monitoring by HBV-DNA measurements and the cut-off of HBV-DNA < 2000 IU/ml = 104 copies per ml for inactive HBsAg carriers.

Body-mass index and progression of hepatitis B: a population-based cohort study in men.

Yu MW, Shih WL, Lin CL, Liu CJ, Jian JW, Tsai KS, Chen CJ.

J Clin Oncol. 2008 Dec 1;26(34):5576-82. Epub 2008 Oct 27.

Rating & Commentary
* Large prospective study in HBsAg-positive individuals over more than 14 years, indicating a small role for excess body weight in the occurrence of HCC and liver failure.

Prevalence and risk factors of hepatic steatosis and its impact on liver injury in Chinese patients with chronic hepatitis B infection.

Shi JP, Fan JG, Wu R, Gao XQ, Zhang L, Wang H, Farrell GC.

J Gastroenterol Hepatol. 2008 Sep;23(9):1419-25.

Rating & Commentary
* Large short-term study evaluating the impact of hepatic steatosis in chronic hepatitis B.

Metabolic syndrome increases the risk of liver cirrhosis in chronic hepatitis B.

Wong GL, Wong VW, Choi PC, Chan AW, Chim AM, Yiu KK, Chan HY, Chan FK, Sung JJ, Chan HL.

Gut. 2009 Jan;58(1):111-7. Epub 2008 Oct 2.

Rating & Commentary
* Large cohort study with liver stiff measurement that suggest a role of the metabolic syndrome in the development of cirrhosis in chronic hepatitis B.

Analysis of hepatitis B genotype changes in chronic hepatitis B infection: Influence of antiviral therapy.

Jardi R, Rodriguez-Frias F, Schaper M, Giggi E, Tabernero D, Homs M, Esteban R, Buti M.

J Hepatol. 2008 Nov;49(5):695-701. Epub 2008 May 6.

Rating & Commentary
* Cohort study suggesting more complexity of genotype classification in chronic hepatitis B than meets the eye; in addition, a genotype difference in sensitivity to nucleoside analog therapy was observed.

Model based analysis of hepatitis B vaccination strategies in the Netherlands.

Kretzschmar M, Mangen MJ, van de Laar M, de Wit A.

Vaccine. 2008 Dec 29. [Epub ahead of print]

Rating & Commentary
* Study presenting evidence for low endemic countries that universal vaccination has the largest preventive effect on the incidence of new infections.

Early serum HBsAg drop: A strong predictor of sustained virological response to pegylated interferon alfa-2a in HBeAg-negative patients.

Moucari R, Mackiewicz V, Lada O, Ripault MP, Castelnau C, Martinot-Peignoux M, Dauvergne A, Asselah T, Boyer N, Bedossa P, Valla D, Vidaud M, Nicolas-Chanoine MH, Marcellin P.

Hepatology. 2008 Nov 19. [Epub ahead of print]

Rating & Commentary
* Small therapeutic study in HBeAg-negative chronic hepatitis B indicating a high positive predictive value for SVR of a 0.5 – 1.0 log drop in HBsAg levels at 12-24 weeks in patients receiving peginterferon therapy.

How I treat and monitor viral hepatitis B infection in patients receiving intensive immunosuppressive therapies or undergoing hematopoietic stem cell transplantation.

Liang R.

Blood. 2009 Jan 14. [Epub ahead of print]

Rating & Commentary
* Clear personal guideline for management of patients with chronic hepatitis B and co-morbidity requiring immunosuppressive therapy.

Occult hepatitis B virus infection in Southern African blacks with hepatocellular carcinoma.

Kew MC, Welschinger R, Viana R.

J Gastroenterol Hepatol. 2008 Sep;23(9):1426-30.

Rating & Commentary
** Study reminding clinicians the limited sensitivity of a single PCR system and the possible need to use several PCR assay systems for optimal diagnosis in anti-HBc positive individuals.