Hope-For-HepB Top10 April 2010
Distinct hepatitis B virus dynamics in the immunotolerant and early immunoclearance phases.
Wang HY, Chien MH, Huang HP, Chang HC, Wu CC, Chen PJ, Chang MH, Chen DS.
J Virol. 2010;84(7):3454-63.
Rating & Commentary
** Virologic study, which demonstrates the influence of the immune host system on the natural history of chronic hepatitis B, and more specifically the influence of the immune host response on the transition from the immune-tolerant to the immune-active phase, and subsequent changes in viral quasi-species.
Evidence for the insufficient evaluation and undertreatment of chronic hepatitis B infection in a predominantly low-income and immigrant population.
Jung CW, Tan J, Tan N, Kuo MN, Ashok A, Eells SJ, Miller LG.
J Gastroenterol Hepatol. 2010;25(2):369-75.
Rating & Commentary
** Survey of 1231 adult patients found to be positive for HBsAg between 1994 and 2006. Further evaluation after HBsAg detection was done in 28% and 16% received HBV treatment. Understanding and dissolving barriers to receiving HBV treatment is urgent.
Multiple Clusters of Hepatitis Virus Infections Associated with Anesthesia for Outpatient Endoscopy Procedures.
Gutelius B, Perz JF, Parker MM, Hallack R, Stricof R, Clement EJ, Lin Y, Xia GL, Punsalang A, Eramo A, Layton M, Balter S.
Gastroenterology. 2010 Mar 27. [Epub ahead of print]
Rating & Commentary
** Description of an outbreak of acute HBV and HCV infections among patients who received anesthesia during endoscopy procedures from the same anaesthesiologist, Carefully review of all infection control measures including anesthesia services in endoscopy units is recommended.
High rates of serological response to a modified hepatitis B vaccination schedule in HIV-infected adults subjects.
Potsch DV, Oliveira ML, Ginuíno C, Miguel JC, Oliveira SA, Silva EF, Moreira RB, Cruz GV, Oliveira AL, Camacho LA, Barroso PF.
Vaccine. 2010;28(6):1447-50.
Rating & Commentary
** Hepatitis B vaccination study in HIV-infected subjects with mostly adequate CD4 counts and low HIV viral load. A double-close 4-injection schedule led to 89% protective antiHBs antibody response, and 78% > 100 IU of antiHBs. The double dose 4 injection schedule should be considered in HIV infected subjects.
Adjuvant interferon therapy after curative therapy for hepatocellular carcinoma (HCC): A meta-regression approach.
Shen YC, Hsu C, Chen LT, Cheng CC, Hu FC, Cheng AL.
J Hepatol. 2010 Mar 24. [Epub ahead of print]
Rating & Commentary
* Methologically careful meta-analysis of adjuvant interferon therapy after curative resection for HCC in patients with underlying chronic hepatitis B or C. Interferon therapy significantly improved 1, 2 and 3 year survival. These data on quantitive estimation of treatment efficacy will help design future clinical trials.
Clinical scoring system to predict hepatocellular carcinoma in chronic hepatitis B carriers.
Wong VW, Chan SL, Mo F, Chan TC, Loong HH, Wong GL, Lui YY, Chan AT, Sung JJ, Yeo W, Chan HL, Mok TS.
J Clin Oncol. 2010;28(10):1660-5.
Rating & Commentary
* Development of a simple clinical score in predict the 5-year risk of HCC among HBV carriers. The following five factors: age, albumin, bilirubin, HBV DNA and cirrhosis are included in the score.
A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection.
Li N, Lai EC, Shi J, Guo WX, Xue J, Huang B, Lau WY, Wu MC, Cheng SQ.
Ann Surg Oncol. 2010;17(1):179-85.
Rating & Commentary
* Nonrandomized comparative study for postoperative antiviral treatment of patients who underwent curative hepatectomy for advanced HCC. Treatment patients (n = 43) received lamivudine with or without adefovir, while controls (n = 36) received no antiviral treatment. Nucleoside analog therapy led to postoperative viral clearance, increased residual liver volume and survival.
Hepatocellular carcinoma surveillance and appropriate treatment options improve survival for patients with liver cirrhosis.
Kuo YH, Lu SN, Chen CL, Cheng YF, Lin CY, Hung CH, Chen CH, Changchien CS, Hsu HC, Hu TH, Lee CM, Wang JH.
Eur J Cancer. 2010;46(4):744-51.
Rating & Commentary
* From a total of 1436 cirrhotic patients with newly diagnosed HCC 318 came from a program of periodic surveillance, the other 1118 were incidentally detected. The overall 3-yaer survival was better for patients in the surveillance group (59% vs 29%), suggesting benefits of surveillance programs.
Nucleos(t)ide Analogues Only Induce Temporary Hepatitis B e Antigen Seroconversion in Most Patients with Chronic Hepatitis B.
Reijnders JG, Perquin MJ, Zhang N, Hansen BE, Janssen HL.
Gastroenterology. 2010 Apr 7. [Epub ahead of print]
Rating & Commentary
* The long-term durability of nucleos(t)ide analogue-induced HBeAg seroconversion was analyzed in detail in 132 patients with chronic hepatitis B virus (HBV) infection. During a median treatment duration of 26 months, HBeAg seroconversion occurred in 46 subjects (35%). Overall, 33 of 42 subjects with follow-up (79%) continued therapy after HBeAg seroconversion. During a median follow-up of 59 months after HBeAg seroconversion, 13 of 42 patients (31%) with complete follow-up demonstrated a durable remission (defined as HBeAg negative and HBV DNA < 10,000 copies/mL). Most patients with or without continued therapy demonstrated serological and/or virological recurrence. Long-term continuation of nucleos(t)ide analogue treatment, irrespective of the occurrence of HBeAg seroconversion, appears to be necessary.
Long-term use of entecavir in nucleoside-naïve Japanese patients with chronic hepatitis B infection.
Yokosuka O, Takaguchi K, Fujioka S, Shindo M, Chayama K, Kobashi H, Hayashi N, Sato C, Kiyosawa K, Tanikawa K, Ishikawa H, Masaki N, Seriu T, Omata M.
J Hepatol. 2010 Mar 24. [Epub ahead of print]
Rating & Commentary
* This study evaluates the long-term efficacy of entecavir in nucleoside-naïve chronic hepatitis B patients in Japan confirms beneficial findings from Western studie. The 3-year cumulative probability of resistance was 3.3% for all patients and 1.7% for the 0.5mg subset.