Hope-For-HepB Top10 November 2009

Silent epidemic of viral hepatitis may lead to boom in serious liver disease.

Kuehn BM.

JAMA. 2009 Nov 11;302(18):1949-54.

Rating & Commentary
*** A review about the public health impact of the viral hepatitis epidemic and a systematic USA approach of preventing liver-related mortality in the future. Each country in the world should now complement their strategy on hepatitis B vaccination with a strategy of screening and treatment of chronic viral hepatitis.

Screening and early treatment of migrants for chronic hepatitis B virus infection is cost-effective.

Veldhuijzen IK, Toy M, Hahné SJ, de Wit GA, Schalm SW, de Man RA, Richardus JH.

Gastroenterology. 2009 Oct 28. [Epub ahead of print]

Rating & Commentary
** Important cost-effectiveness study demonstrating that one-time screening of a targeted population for HBV, such as migrants from intermediate and high-endemic countries in a low-endemic country such as the Netherlands, is likely to be cost-effective.

Severe lactic acidosis during treatment of chronic hepatitis B with entecavir in patients with impaired liver function.

Lange CM, Bojunga J, Hofmann WP, Wunder K, Mihm U, Zeuzem S, Sarrazin C.

Hepatology. 2009 Dec;50(6):2001-6.

Rating & Commentary
** The efficacy and side effect profile of ETV in HBV patients with advanced liver disease with impaired liver function is still unknown. This is a case series of 16 patients, of whom five patients developed lactic acidosis during entecavir treatment. These five patients all had a MELD>20. Lactic acidosis was lethal in one patient but resolved in the other cases after termination/interruption of entecavir treatment.

Europe's hepatitis challenge: Defusing the "viral time bomb"

Piorkowsky NY.

J Hepatol. 2009 Dec;51(6):1068-73

Rating & Commentary
** For a sustainable change in the perception of liver diseases by the public and decision-makers in public health and a subsequent improvement of the situation for patients and specialists, it will be important for both to move beyond the immediate doctor-patient relationship and address jointly a wider audience.

Prevalence of hepatitis B surface antigen among refugees entering the United States between 2006 and 2008.

Rein DB, Lesesne SB, O'Fallon A, Weinbaum CM.

Hepatology. 2009 Sep 29. [Epub ahead of print]

Rating & Commentary
* Epidemiological study investigating the prevalence of HBsAg among refugees entering the US. CDC recommends hepatitis B surface antigen (HBsAg) testing to identify chronic hepatitis B virus infection for foreign-born persons from countries or regions with HBsAg prevalence of >/=2%. Overall, the prevalence was 2.8%, prevalence was highest among refugees from Africa and Southeast Asia, and lowest among refugees from the Middle East and South/Central America.

The course of inactive hepatitis B in hepatitis-C-coinfected patients treated with interferon and ribavirin.

Viganò M, Aghemo A, Iavarone M, Rumi MG, Agnelli F, Lampertico P, Donato MF, Colombo M.

Antivir Ther. 2009;14(6):789-96.

Rating & Commentary
* Inactive hepatits B carriers co-infected with HCV and treated with IFN-RBV combination therapy carry a low risk of on- and off-treatment HBV reactivation and a 40 percent rate of SVR.

Reduction in hepatitis B virus seroprevalence among U.S.-born children of foreign-born Asian parents -- benefit of universal infant hepatitis B vaccination.

Shuler CM, Fiore AE, Neeman R, Bell BP, Kuhnert W, Watkins S, Kilgour K, Arnold KE.

Vaccine. 2009 Oct 9;27(43):5942-7.

Rating & Commentary
* US study which shows that after implementation of recommendations for universal infant hepatitis B vaccination, HBV infection prevalence among children of foreign-born Asian parents declined dramatically.

Antibody kinetics among 8-10 years old respondents to hepatitis B vaccination in a low endemic country and the effect of a booster dose given 5 or 10 years later.

Gilca V, De Serres G, Boulianne N, De Wals P, Murphy D, Trudeau G, Massé R, Duval B.

Vaccine. 2009 Oct 9;27(43):6048-53.

Rating & Commentary
* Follow-up study of young adults vaccinated at the age of 8-10, which demonstrates persistence of immunity in virtually all young adults for 5-10 years.

Adherence to Screening for Hepatocellular Carcinoma Among Patients with Cirrhosis or Chronic Hepatitis B in a Community Setting.

Wong CR, Garcia RT, Trinh HN, Lam KD, Ha NB, Nguyen HA, Nguyen KK, Levitt BS, Nguyen MH.

Dig Dis Sci. 2009 Oct 30. [Epub ahead of print]

Rating & Commentary
* Current guidelines recommend screening for HBV every 6-12 months in specific HBV patients, such as subjects who have already developed cirrhosis. In this cohort of 556 HBV patients with a high risk for HCC, 40% received poor or no screening. More frequent clinic visits appeared to be a strong independent predictor of improved screening adherence.

Lamivudine maintenance beyond one year after HBeAg seroconversion is a major factor for sustained virologic response in HBeAg-positive chronic hepatitis B.

Lee HW, Lee HJ, Hwang JS, Sohn JH, Jang JY, Han KJ, Park JY, Kim DY, Ahn SH, Paik YH, Lee CK, Lee KS, Chon CY, Han KH.

Hepatology. 2009 Nov 9. [Epub ahead of print]

Rating & Commentary
* Cohort-study exploring sustained response after discontinuation of lamivudine after HBeAg loss or seroconversion. After five years of follow-up about 30% of patients demonstrated relapse, which appeared to be lower than observed in other studies. Age and duration of consolidation therapy after HBeAg loss or seroconversion were the most important predictors of sustained response.