Hope-For-HepB Top10 November 2010

Time for universal HIV and HBV screening for patients with cancer.

Cainelli F, Vento S.

Lancet Oncol. 2010 Oct;11:916-8.

Rating & Commentary
** Up-to-date article with data which argues for universal screening for HBV and HIV in patients with cancer.

Tenofovir disoproxil fumarate rescue therapy following failure of both lamivudine and adefovir dipivoxil in chronic hepatitis B.

Patterson SJ, George J, Strasser SI, Lee AU, Sievert W, Nicoll AJ, Desmond PV, Roberts SK, Locarnini S, Bowden S, Angus PW.

Gut. 2010 Oct 29. [Epub ahead of print]

Rating & Commentary
** A prospective open-label study of sixty pretreated HBV patients who received rescue therapy with tenofovir. All patients had previously failed lamivudine and adefovir dipivoxil. Thirty-eight patients (63%) were switched from ADV to TDF, the remainder from ADV/LAM to TDF/LAM. At 48 and 96 weeks, 27/59 (46%) and 38/59 (64%) patients achieved a HBV DNA <15IU/ml. In conclusion, TDF retained significant antiviral efficacy in this heavily pretreated group of patients although this appears diminished in comparison with naïve patients.

Profiles of HBV DNA in a large population of Chinese patients with chronic hepatitis B: Implications for antiviral therapy.

Fung J, Seto WK, Lai CL, Yuen J, Wong DK, Yuen MF.

J Hepatol. 2010 Oct 19. [Epub ahead of print]

Rating & Commentary
** 1400 Treatment-naïve CHB patients had their HBV DNA levels determined. In subjects aged <25, 26-35, 36-45, 46-55, and >55years, there was a decreasing trend of HBV DNA levels of 9.9, 9.3, 8.2, 7.4, and 7.3 log copies/ml, respectively  in HBeAg-positive subjects, while the pattern was reversed with HBV DNA levels of 3.7, 4.4, 4.7, 4.9, and 5.2 log copies/ml, respectively in HBeAg-negative subjects. In this study population, by applying the AASLD, EASL, and APASL guidelines, 64%, 99%, and 64% would be eligible for antiviral therapy, respectively, in HBeAg-positive patients (with elevated ALT), and 38%, 72%, and 43%, respectively, in HBeAg-negative patients (with elevated ALT).

Serum HBsAg quantification to predict response to peginterferon therapy of e antigen positive chronic hepatitis B.

Chan HL, Wong VW, Chim AM, Chan HY, Wong GL, Sung JJ.

Aliment Pharmacol Ther. 2010 Dec;32:1323-31.

Rating & Commentary
* Exploratory study on the predictive value of serum hepatitis B surface antigen quantification response to peginterferon therapy in chronic hepatitis B. Twenty-one of 92 (23%) patients achieved sustained response. An hepatitis B surface antigen cut-off at 300 IU/mL at month 6 could give the maximum combination of sensitivity (62%) and specificity (89%) to predict sustained response.

Clinical outcomes of liver transplantation for HBV-related hepatocellular carcinoma: data from the NIH HBV OLT study.

Han SH, Reddy KR, Keeffe EB, Soldevila-Pico C, Gish R, Chung RT, Degertekin B, Lok A; the NIH HBV OLT Study Group.

Clin Transplant. 2010 Nov 16. [Epub ahead of print]

Rating & Commentary
* Prospective cohort study of 98 patients (52.4% in the NIH HBV OLT cohort) who underwent OLT months for HBV-related HCC. With a mean follow-up of 36 months post-OLT, 12 patients developed recurrence of HCC. Only AFP>200 at the time of transplantation was associated to recurrence. HCC is the most common indication for OLT in patients with chronic hepatitis B in the era of more effective oral antivirals.

Impact of virologic breakthrough and HBIG regimen on hepatitis B recurrence after liver transplantation.

Degertekin B, Han SH, Keeffe EB, Schiff ER, Luketic VA, Brown RS Jr, Emre S, Soldevila-Pico C, Reddy KR, Ishitani MB, Tran TT, Pruett TL, Lok AS; NIH HBV-OLT Study Group.

Am J Transplant. 2010 Aug;10:1823-33.

Rating & Commentary
* Prospective cohort study of 183 patients transplanted between 2001 and 2007 and followed for a median of 42 months (range 1-81) post-OLT. Cumulative rates of HBV recurrence at 1 and 5 years were 3% and 9%, respectively. Low rates of HBV recurrence can thus be accomplished with all the HBIG regimens used when combined with antiviral therapy.

Transient elastography in chronic hepatitis B: an Asian perspective.

Kim SU, Han KH, Ahn SH.

World J Gastroenterol. 2010 Nov 7;16:5173-80.

Rating & Commentary
* A review on elastography (fibroscan), how it helps physicians to decide treatment strategies, predict prognosis, and monitor disease progression in patients with chronic liver disease and to screen the general population to identify high risk patients with potential liver disease.

Potential short-term mortality risk in patients undergoing entecavir treatment for spontaneous exacerbation of chronic hepatitis B: Fact or bias?

Shouval D.

J Hepatol. 2010 Oct 21. [Epub ahead of print]

Rating & Commentary
* Editorial warning on possible risk of entecavir in patients with impaired liver function.

RNA Interference inhibits hepatitis B virus of different genotypes in vitro and in vivo.

Zhang YL, Cheng T, Cai YJ, Yuan Q, Liu C, Zhang T, Xia DZ, Li RY, Yang LW, Wang YB, Yeo AE, Shih JW, Zhang J, Xia NS.

BMC Microbiol. 2010 Aug 10;10:214.

Rating & Commentary
* In vitro study and study in mice which demonstrate that siRNA might be a promising therapeutic option for the treatment of HBV in the future.

Efficacy of switching to telbivudine in chronic hepatitis B patients treated previously with lamivudine.

Safadi R, Xie Q, Chen Y, Yin YK, Wei L, Hwang SG, Zuckerman E, Jia JD, Lopez P.

Liver Int. 2010 Oct 29. [Epub ahead of print]

Rating & Commentary
* Randomized, double-blind, trial which assessed the antiviral efficacy of telbivudine switch in chronic hepatitis B (CHB) patients who exhibited persistent viraemia under lamivudine therapy and demonstrated that switch to telbivudine improves virological outcomes in CHB patients.