Hope-For-HepB Top10 May 2010
Nomograms for risk of hepatocellular carcinoma in patients with chronic hepatitis B virus infection.
Yang HI, Sherman M, Su J, Chen PJ, Liaw YF, Iloeje UH, Chen CJ.
J Clin Oncol. 2010 May; 28:2437-44.
Rating & Commentary
** The study based on 3653 patients with chronic hepatitis B describes the development and validation of a 5- and 10-year risk score for HCC. Calculation of the risk score is easy by the use of nomograms. Prediction risk of HCC may facilitate risk communication between patients and clinicians.
A novel liver stiffness measurement-based prediction model for cirrhosis in hepatitis B patients.
Kim BK, Han KH, Park JY, Ahn SH, Chon CY, Kim JK, Paik YH, Lee KS, Park YN, Kim DY.
Liver Int. 2010 May 21. [Epub ahead of print]
Rating & Commentary
** Assessment of cirrhosis is an important clinical step in the management of chronic hepatitis B. This study suggest that the measurement of liver stiffness, corrected for ALT value, can be improved by combination of 2 other factors: spleen diameter and platelets.
Survey of HBsAg-positive pregnant women and their infants regarding measures to prevent maternal-infantile transmission.
Guo Y, Liu J, Meng L, Meina H, Du Y.
BMC Infect Dis. 2010 Feb;10:26.
Rating & Commentary
* This retrospective study provides insight how proven and unproven measures to prevent vertical transmission of hepatitis B are implemented in daily practice. Proven highly effective measure such as passive-active immunization of neonates had suboptimal compliance (86%) and undocumented efficacy, whereas unproven measures as hepatitis B immunoglobulin during pregnancy (90%), cesarean section (82%) bottle feeding (46%) were implemented in surprisingly high percentages. Awareness is nicely followed by action, but hopefully thereafter by more focused action.
Incidence and Determinants of Spontaneous Hepatitis B Surface Antigen Seroclearance: A Community-based Follow-up Study.
Liu J, Yang HI, Lee MH, Lu SN, Jen CL, Wang LY, You SL, Iloeje UH, Chen CJ; R.E.V.E.A.L.-HBV Study Group.
Gastroenterology. 2010 Apr 28. [Epub ahead of print]
Rating & Commentary
** Cohort study on the natural history of 3087 individuals with chronic hepatitis B showing that the annual incidence rate of HBsAg clearance within a large Asian cohort of predominantly middle-aged man was approximately 2,5%. HBsAg clearance was shown to be related to low baseline viral load.
Incidence of hepatocellular carcinoma in chronic hepatitis B patients receiving nucleos(t)ide therapy: A systematic review.
Papatheodoridis GV, Lampertico P, Manolakopoulos S, Lok A.
J Hepatol. 2010 Apr 27. [Epub ahead of print]
Rating & Commentary
** Systematic review confirming the more than 50% reduction in HCC incidence in chronic hepatitis B by nucleos(t)ide analogue therapy.
Prevention of hepatocellular carcinoma in the Asia-Pacific region: consensus statements.
Asia-Pacific Working Party on Prevention of Hepatocellular Carcinoma.
J Gastroenterol Hepatol. 2010 Apr; 25:657-63.
Rating & Commentary
* Useful public health overview on various strategies to prevent hepatocellular carcinoma concluding that effective hepatitis B vaccination is the most basic approach. Prevention of HCV by screening blood donor and reducing HCV transmission in health-care setting and drug scene are also vital. There is strong evidence that effective antiviral therapy to control HBV infection or eradicate HCV substantially reduces HCC risk.
Carriers of inactive hepatitis B virus are still at risk for hepatocellular carcinoma and liver-related death.
Chen JD, Yang HI, Iloeje UH, You SL, Lu SN, Wang LY, Su J, Sun CA, Liaw YF, Chen CJ; Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer in HBV (REVEAL-HBV) Study Group.
Gastroenterology. 2010 May;138:1747-54.
Rating & Commentary
* Prospective cohort study (REVEAL), which demonstrated that inactive HBV carriers, compared to HBsAg-negative controls, still have a slightly elevated risk for development of HCC (annual risk: 0.06 vs. 0.02%) and liver-related death (annual risk: 0.04 vs. 0.02%).
A Randomized Trial of Peginterferon alpha-2a With or Without Ribavirin for HBeAg-Negative Chronic Hepatitis B.
Rijckborst V, Ter Borg MJ, Cakaloglu Y, Ferenci P, Tabak F, Akdogan M, Simon K, Raptopoulou-Gigi M, Ormeci N, Zondervan PE, Verhey E, van Vuuren AJ, Hansen BE, Janssen HL.
Am J Gastroenterol. 2010 May 11. [Epub ahead of print]
Rating & Commentary
* Randomized clinical trial which demonstrates that in HBeAg-negative, mostly genotype D, HBV patients, peginterferon results in a sustained response in 18% of patients (HBV DNA < 10.000 copies/mL and ALT normalization). Addition of ribavirin did not improve response to therapy.
Long-Term Effect of Interferon Therapy in Patients with HBeAg Positive Chronic Hepatitis B Infection.
Senturk H, Baysal B, Tahan V, Zerdali H, Ozaras R, Tabak F, Mert A, Canbakan B, Tabak O, Ozbay G.
Dig Dis Sci. 2010 May 14. [Epub ahead of print]
Rating & Commentary
* Long-term follow-up study from Turkey, which shows that in HBeAg-positive, genotype D HBV-infected patients, treatment with standard IFN-alfa 2b for six months resulted in only 10% of patients demonstrating a sustained response (HBeAg-negativity, HBV DNA < 2.000 IU/mL and ALT normalization) after 10 years of follow-up. This study confirms earlier LTFU concluding that sustained response to (pegylated) interferon in genotype D patients is low.
Increasing hepatitis B viral load is associated with risk of significant liver fibrosis in HBeAg-negative but not HBeAg-positive chronic hepatitis B.
Croagh CM, Bell SJ, Slavin J, Kong YX, Chen RY, Locarnini S, Desmond PV.
Liver Int. 2010 May 21. [Epub ahead of print]
Rating & Commentary
** Prognosis of chronic hepatitis B is overall related to HBV DNA levels, but this study identifies that HBV DNA levels are significantly related tot fibrosis only in patients with HBeAg-negative CHV.