Hope-For-HepB Top10 September 2009

Factors that Predict Response of Patients with Hepatitis B e Antigen-Positive Chronic Hepatitis B to Peginterferon-alpha.

Buster EH, Hansen BE, Lau GK, Piratvisuth T, Zeuzem S, Steyerberg EW, Janssen HL.

Gastroenterology. 2009 Sep 5. [Epub ahead of print]

Rating & Commentary
** Prediction of virological response to peginterferon is clinically relevant. This study based on patients from two large randomized controlled trials confirmed the predictive value of HBV genotype, ALT > 2 x ULN, HBV DNA < 2 x 108 IU/md, age and sex. Nomograms for each genotype allow estimation of chance of SVR.

The effects of hormonal contraceptive use among women with viral hepatitis or cirrhosis of the liver: a systematic review.

Kapp N, Tilley IB, Curtis KM.

Contraception. 2009 Oct;80(4):381-6.

Rating & Commentary
* Systematic review pointing to the clinical relevant finding that the use of oral contraceptives have no effect on the outcome of acute or chronic hepatitis B.

Systematic review and meta-analysis of interferon after curative treatment of hepatocellular carcinoma in patients with viral hepatitis.

Breitenstein S, Dimitroulis D, Petrowsky H, Puhan MA, Müllhaupt B, Clavien PA.

Br J Surg. 2009 Sep;96(9):975-81.

Rating & Commentary
* Systematic review on the adjuvant effect of IFN after curative treatment for hepatocellular carcinoma with inclusion of 620 patients from 7 randomized controlled trials. Both tumor recurrence as 2-year mortality were significantly reduced by adjuvant IFN therapy.

Rescue monotherapy in lamivudine-resistant hepatitis B e antigen-positive chronic hepatitis B: adefovir versus entecavir.

Lee JM, Kim HJ, Park JY, Lee CK, Kim do Y, Kim JK, Lee HW, Paik YH, Lee KS, Han KH, Chon CY, Hong SP, Nguyen T, Ahn SH.

Antivir Ther. 2009;14(5):705-12.

Rating & Commentary
* Study attempting to compare the efficacy of adefovir (ADV) and entecavir (ETV) in 160 HBeAg positive patients with confirmed genotypic lamivudine resistance. ADV and ETV showed comparable efficacy after 52 weeks of therapy, in terms of percentage undetectable HBV DNA, ALT normalization and virological breakthrough.

Renal dysfunction in chronic hepatitis B patients treated with adefovir dipivoxil.

Ha NB, Ha NB, Garcia RT, Trinh HN, Vu AA, Nguyen HA, Nguyen KK, Levitt BS, Nguyen MH.

Hepatology. 2009 Sep;50(3):727-34.

Rating & Commentary
* Cohort study in 290 chronic hepatitis B patients (145 therapy with adefovir and 145 matched controls) to estimate the incidence and clinical importance of renal dysfunction by adefovir. The incidence for eGFR </= 50 ml/min was 5% per year with adefovir and 1.4% per year for controls. Patients who were > 50 years, had minor baseline renal impairment, hypertension or diabetes were at greatest risk.

Antiviral therapy of chronic hepatitis B: opportunities and challenges in Asia.

Liaw YF.

J Hepatol. 2009 Aug;51(2):403-10.

Rating & Commentary
* Review article summarizing the challenges in Asia to let patients with chronic hepatits B benefit from recent advances in therapeutic agents.

Prevalence, viral replication efficiency and antiviral drug susceptibility of rtQ215 polymerase mutations within the hepatitis B virus genome.

Amini-Bavil-Olyaee S, Herbers U, Mohebbi SR, Sabahi F, Zali MR, Luedde T, Trautwein C, Tacke F.

J Hepatol. 2009 Oct;51(4):647-54

Rating & Commentary
* In a cohort of 249 HBV infected patients, 14.5% (36/249) showed mutations in the rtQ215 locus, which was higher in LAM-treated patients compared to naïve patients. These substitutions however do neither impair the viral replication efficiency nor susceptibility to LAM or ADV in vitro, and therefore likely represents background polymorphisms rather than resistance mutations with clinical implications.

Virologic, serologic, and biochemical outcomes through 2 years of treatment with entecavir and lamivudine in nucleoside-naïve Chinese patients with chronic hepatitis B: a randomized, multicenter study.

Yao G, Chen C, Lu W, Ren H, Tan D, Wang Y, Xu D, Liu J, Xu D, Llamoso C.

Hepatol Int. 2008 Dec;2(4):486-93.

Rating & Commentary
* Large randomized controlled trial confirming the 2-year efficacy of entecavir for Chinese patients with chronic hepatitis B as well as a safety profile comparable with lamivudine.

Evaluation of the impact of hepatitis B vaccination among children born during 1992-2005 in China.

Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, Zhang Y, Liu J, Gong X, Chen Y, Wang F, Zheng H, Wang F, Guo J, Jia Z, Ma J, Wang H, Luo H, Li L, Jin S, Hadler SC, Wang Y.

J Infect Dis. 2009 Jul;200(1):39-47.

Rating & Commentary
* National evaluation of hepatitis B vaccination in China over the period 1992 till 2007. HB vaccine coverage increased from 30% of children born in 1992 to 93% of children born in 2005. The prevalence of HBsAg has fallen below 1% in children born after 1999.

Lower baseline ALT cut-off values and HBV DNA levels better differentiate HBeAg- chronic hepatitis B patients from inactive chronic carriers.

Assy N, Beniashvili Z, Djibre A, Nasser G, Grosovski M, Nseir W.

World J Gastroenterol. 2009 Jun;15(24):3025-31.

Rating & Commentary
* For accurate differentiation of inactive HBsAg carriers from HBeAg-negative chronic hepatitis B at one point in time there is no routine method available. Stringent normal values for ALT (30 IU/L in men, 19 IU/L in women) together with cut-off values for HBVDNA as proposed by AASLD / NIH in 2000 allow clinical risk-assessment for well defined groups.