Hope-For-HepB Top10 March 2010

Relative Roles of HBsAg Seroclearance and Mortality in the Decline of HBsAg Prevalence With Increasing Age.
Tai DI, Tsay PK, Chen WT, Chu CM, Liaw YF.
Am J Gastroenterol. 2010 Mar 2. [Epub ahead of print]
Rating & Commentary
** A prospective cohort study of 6621 HBsAg-positive subject (21% HBeAg-positive) in Taiwan showed after a mean follow-up period of 13.6+/-5.4 years a significantly higher HBsAg seroclearance rate (555 cases, 8,4%) than mortality (97 cases, 1,5%), of which only 40% were liver-related cases. HBsAg seroclearance is the main reason for decreasing HBsAg prevalence with increasing age.

Hepatitis B surface antigen (HBsAg) levels in the natural history of hepatitis B virus (HBV)-infection: a European perspective.
Jaroszewicz J, Serrano BC, Wursthorn K, Deterding K, Schlue J, Raupach R, Flisiak R, Bock CT, Manns MP, Wedemeyer H, Cornberg M.
J Hepatol. 2010;52(4):514-22.
Rating & Commentary
* An European study of 226 non-treated HBV patients demonstrates that quantitative HBsAg levels show significant differences during the natural course of HBV-infection and between HBV-genotypes. Patients in the immune control phase who progressed to HBeAg-negative HBV infection had a significant higher HBsAg level at baseline, compared to subjects who remained in the immune control phase throughout follow-up.

Hepatitis B surface antigen levels during the natural history of chronic hepatitis B: a perspective on Asia.
Nguyen T, Thompson AJ, Bowden S, Croagh C, Bell S, Desmond PV, Levy M, Locarnini SA.
J Hepatol. 2010;52(4):508-13.
Rating & Commentary
* An Asian study of 220 treatment-naive patients, which confirms the European findings on quantitative HBsAg levels during the natural history of chronic HBV infection: mean HBsAg titres are highest in immunetolerance, still high in immuneclearance, lowest in non/low replicative phase and relatively low in e-negative chronic hepatitis.

Mortality after chronic hepatitis B virus infection: a linkage study involving 2 million parous women from Taiwan.
Fwu CW, Chien YC, Nelson KE, Kirk GD, You SL, Kuo HS, Feinleib M, Chen CJ.
J Infect Dis. 2010; 201(7):1016-23.
Rating & Commentary
* This study investigates the overall and disease-specific mortality rates in a nationwide cohort of women of 2 million women after they were screened for hepatitis B surface antigen (HBsAg) during pregnancy. After a mean follow-up of 11 years 14.524 women had died. Mortality among HBsAg-carriers from liver disease was 6-fold increased; in addition, there was a select but significant over mortality from non-Hodgkin lymphoma and bile duct cancer.

Hypophosphatemic osteomalacia after low-dose adefovir dipivoxil therapy for hepatitis B.
Wong T, Girgis CM, Ngu MC, Chen RC, Emmett L, Archer KA, Seibel MJ.
J Clin Endocrinol Metab. 2010;95(2):479-80.
Rating & Commentary
* There are concerns about renal toxicity of adefovir with ADV, and more specifically tubular dysfunction, which can result in hypophospathemia. This is a case report of a patients with hypophosphatemic osteomalacia after low-dose adefovir dipivoxil therapy for hepatitis B.

Effect of puberty onset on spontaneous hepatitis B virus e antigen seroconversion in men.
Wu JF, Tsai WY, Hsu HY, Ni YH, Chen HL, Tsuei DJ, Chang MH.
Gastroenterology. 2010;138(3):942-8.
Rating & Commentary
* A large prospective cohort study, which demonstrates that early-onset puberty and increased SRD5A2 enzyme activity are associated with earlier HBeAg seroconversion, higher serum alanine aminotransferase levels, and a greater HBV viral load decrement in chronic HBV infected males.

Hepatitis B virus genotype C is associated with more severe liver fibrosis than genotype B.
Chan HL, Wong GL, Tse CH, Chim AM, Yiu KK, Chan HY, Sung JJ, Wong VW.
Clin Gastroenterol Hepatol. 2009;7(12):1361-6.
Rating & Commentary
* Large cross-sectional study which confirms, using transient elastography, that genotype C HBV was associated with more severe liver fibrosis than genotype B HBV, probably because of delayed HBeAg seroconversion and prolonged active disease.

The role of entecavir in preventing hepatitis B recurrence after liver transplantation.
Xi ZF, Xia Q, Zhang JJ, Chen XS, Han LZ, Wang X, Shen CH, Luo Y, Xin TY, Wang SY, Qiu de K.
J Dig Dis. 2009;10(4):321-7.
Rating & Commentary
* This cohort study which compared combination therapy using ETV and HBIG to standard of treatment (LAM and HBIG) in preventing hepatitis B recurrence after liver transplantation suggests that entecavir combined with low dosages of HBIG is equally effective and safe compared to LAM and HBIG in preventing hepatitis B recurrence after liver transplantation.

Comparison between quantitative hepatitis B surface antigen, hepatitis B e-antigen and hepatitis B virus DNA levels for predicting virological response to pegylated interferon-alpha-2b therapy in hepatitis B e-antigen-positive chronic hepatitis B.
Tangkijvanich P, Komolmit P, Mahachai V, Sa-Nguanmoo P, Theamboonlers A, Poovorawan Y.
Hepatol Res. 2010 Jan 11. [Epub ahead of print]
Rating & Commentary
* This study compares the clinical applicability of quantitative serum hepatitis B surface antigen (HBsAg), hepatitis B e-antigen (HBeAg) and hepatitis B virus (HBV) DNA for predicting virological response (VR) to pegylated interferon (PEG-IFN) therapy. Quantitative serum HBeAg may be superior to HBsAg and HBV DNA as a prediction of HBeAg seroconversion. Kinetics of HBsAg levels on therapy may help predict HBsAg clearance after treatment.

Neither Diabetes Mellitus nor Overweight Is a Risk Factor for Hepatocellular Carcinoma in a Dual HBV and HCV Endemic Area: Community Cross-Sectional and Case-Control Studies.
Tung HD, Wang JH, Tseng PL, Hung CH, Kee KM, Chen CH, Chang KC, Lee CM, Changchien CS, Chen YD, Lu SN.
Am J Gastroenterol. 2010 Jan 5. [Epub ahead of print]
Rating & Commentary
* On the basis of community-based cross-sectional and case-controlled studies neither diabetes mellitus nor overweight was a risk factor for HCC in the dual HBV and HCV endemic area of Taiwan.