Hope-For-HepB Top10 May 2009

A 28-year study of the course of hepatitis Delta infection: a risk factor for cirrhosis and hepatocellular carcinoma.

Romeo R, Del Ninno E, Rumi M, Russo A, Sangiovanni A, de Franchis R, Ronchi G, Colombo M.

Gastroenterology. 2009;136(5):1629-38.

Rating & Commentary
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Retrospective cohort study of 299 HDV-HBV co-infected patients with a mean follow-up of 233 months. Approximately one-third of patients demonstrated with liver cirrhosis at baseline. The cumulative probability of cirrhosis at 20 years was 55% with an incidence rate of 4% per year in non-cirrhotic patients at baseline. Clinical decompensation occurred at an annual incidence rate of 2.7%, and HCC developed with an incidence rate of 2.8% per year in all patients. Persistent HDV replication was an important predictor of progressive liver disease and liver-related mortality.

Recommendations for identification and public health management of persons with chronic hepatitis B virus infection.

Weinbaum CM, Mast EE, Ward JW.

Hepatology. 2009;49(5 Suppl):S35-44.

Rating & Commentary
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Key publication for awareness of chronic hepatitis B as a public health issue in countries with low-endemicy of hepatitis B.

Side effects of long-term oral antiviral therapy for hepatitis B.

Fontana RJ.

Hepatology. 2009;49(5 Suppl):S185-95.

Rating & Commentary
**
Useful balanced summary of safety and potential side-effects of oral antiviral therapy for hepatitis B.

Patient to patient transmission of hepatitis B virus: a systematic review of reports on outbreaks between 1992 and 2007.

Lanini S, Puro V, Lauria FN, Fusco FM, Nisii C, Ippolito G.

BMC Med. 2009;7:15.

Rating & Commentary
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Systematic review of hepatitis B virus outbreaks published between 1992 and 2007 within the EU and USA, which shows that breaches in infection control measures, such as administration of drugs using multi-vial compounds and capillary blood sampling, are the most frequent routes for patient-to-patient transmission of hepatitis B virus.

Development of Hepatocellular Carcinoma after Seroclearance of Hepatitis B Surface Antigen.

Tong MJ, Nguyen MO, Tong LT, Blatt L.

Clin Gastroenterol Hepatol. 2009 Apr 23. [Epub ahead of print]

Rating & Commentary
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Small cohort study of 35 chronic hepatitis B patients who experienced HBsAg-loss. During long-term follow-up after HBsAg loss hepatocellular carcinoma developed in 4 cirrhotic patients, which might indicate that HCC surveillance should be continued in HBV patients, even after HBsAg loss.

The Duration of Lamivudine Therapy for Chronic Hepatitis B: Cessation vs. Continuation of Treatment After HBeAg Seroconversion.

Fung J, Lai CL, Tanaka Y, Mizokami M, Yuen J, Wong DK, Yuen MF.

Am J Gastroenterol. 2009 May 19. [Epub ahead of print]

Rating & Commentary
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Observational study in which patients who stopped lamivudine after HBeAg seroconversion (n=22) were compared with 79 patients who continued to receive lamivudine (n=79). During a median follow-up of 20 months after stopping lamivudine 14 (64%) of 22 patients had virological rebound, with a cumulative incidence of 82% at 4 years. None of the patients demonstrated undetectable HBV DNA at the end of follow-up, whereas 62 (78%) of 79 patients who continued lamivudine, had undetectable HBV DNA at last follow-up (median 79 months). Lamivudine-resistant mutations occurred in eight patients (10%) in this group.

An Investigation of Perinatal Hepatitis B Virus Infections Among a High Risk Population: The Delivery Hospital as a Safety Net.

Fischer G, Wang S, Ahring S, Fowler K, Hainline S, Chinglong M, Jacques-Carroll L, Bell B, Williams I.

Pediatr Infect Dis J. 2009 May 18. [Epub ahead of print]

Rating & Commentary
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Passive-active immunization of neonates from HBsAg-positive mothers was introduced more than a decade ago. This study reviews compliance in daily practice and identifies delivery in hospital as a safety net measure to prevent perinatal HBV transmission in high-risk populations.

HBV superinfection in HCV chronic carriers: a disease that is frequently severe but associated with the eradication of HCV.

Sagnelli E, Coppola N, Pisaturo M, Masiello A, Tonziello G, Sagnelli C, Messina V, Filippini P.

Hepatology. 2009;49(4):1090-7.

Rating & Commentary
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A long-term follow-up study, which compared 29 chronic hepatitis C carriers with a acute hepatitis B superinfection, to 29 HCV-negative patients with acute hepatitis B infection. Although the first group demonstrated a more severe course more frequently, it was shown that HBV superinfection in HCV chronic carriers may also lead to clearance of chronic HCV infection, especially in patients with a severe course.

Results of up to 2 years of entecavir vs lamivudine therapy in nucleoside-naïve HBeAg-positive patients with chronic hepatitis B.

Chang TT, Chao YC, Gorbakov VV, Han KH, Gish RG, de Man R, Cheinquer H, Bessone F, Brett-Smith H, Tamez R.

J Viral Hepat. 2009 Apr 30. [Epub ahead of print]

Rating & Commentary
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Report of second year follow-up of the pivotal entecavir studies in chronic hepatitis B.

Viral dynamics of hepatitis B virus DNA in human immunodeficiency virus-1-hepatitis B virus coinfected individuals: similar effectiveness of lamivudine, tenofovir, or combination therapy.

Lewin SR, Ribeiro RM, Avihingsanon A, Bowden S, Matthews G, Marks P, Locarnini SA, Ruxrungtham K, Perelson AS, Dore GJ.

Hepatology. 2009;49(4):1113-21.

Rating & Commentary
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A viral kinetics substudy of a randomized (1:1:1) trial of tenofovir (TDF) versus lamivudine (LAM) versus TDF/LAM within an efavirenz based HAART regimen initiated in HIV-1-HBV co infected antiretroviral naïve individuals in Thailand. A biphasic decline in HBV DNA was observed in almost all patients, but no significant differences were seen in HBV viral dynamic parameters between the three treatments groups.

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