Hope-For-HepB Top 10 October 2010
Liaw YF, Sheen IS, Lee CM, Akarca US, Papatheodoridis GV, Suet-Hing Wong F, Chang TT, Horban A, Wang C, Kwan P, Buti M, Prieto M, Berg T, Kitrinos K, Peschell K, Mondou E, Frederick D, Rousseau F, Schiff ER.
Hepatology. 2010 Sep 1. [Epub ahead of print]
Rating & Commentary
*** A phase 2, double-blind randomized study of 112 patients with CHB and decompensated liver disease, receiving tenofovir (n = 45), emtricitabine-tenofovir (fixed-dose combination; n = 45) or entecavir (n = 22). All treatment regimes were well tolerated. At week 48, HBV DNA was <400 copies/mL (69 IU/mL) in 70% (tenofovir), 88% (emtricitabine-tenofovir), and 73% (entecavir) of patients. Child- Pugh and MELD scores improved in all groups.
Persistence and adherence to nucleos(t)ide analogue treatment for chronic hepatitis B.
Chotiyaputta W, Peterson C, Ditah FA, Goodwin D, Lok AS.
J Hepatol. 2010 Aug 20. [Epub ahead of print]
Rating & Commentary
*** This study aimed to determine the persistence rates and the adherence rates to nucleos(t)ide analogues in 11.100 patients with chronic hepatitis B and the factors associated with adherence. The mean adherence rate was 81%. New patients and young adult were less likely to be adherent.
Loras C, Gisbert JP, Mínguez M, Merino O, Bujanda L, Saro C, Domenech E, Barrio J, Andreu M, Ordás I, Vida L, Bastida G, González-Huix F, Piqueras M, Ginard D, Calvet X, Gutiérrez A, Abad A, Torres M, Panés J, Chaparro M, Pascual I, Rodriguez-Carballeira M, Fernández-Bañares F, Viver JM, Esteve M; REPENTINA study; GETECCU (Grupo Español de Enfermedades de Crohn y Colitis Ulcerosa) Group.
Gut. 2010 Oct;59:1340-6.
Rating & Commentary
** Follow-up study of162 patients with IBD with HBV and/or HCV infection. 104 had HBV markers (25 HBsAg positive) and 74 had HCV markers (51 HCV-RNA positive). Liver dysfunction was observed in 9 of 25 HBsAg positive patients (36%), 6 of whom developed hepatic failure. No definite HBV reactivations were found in anti-HBc positive patients lacking HBsAg. This study underlines the importance of antiviral prohylaxis, especially in HBsAg-positive patients.
Three-Year Efficacy and Safety of Tenofovir Disoproxil Fumarate Treatment for Chronic Hepatitis B.
Heathcote EJ, Marcellin P, Buti M, Gane E, de Man RA, Krastev Z, Germanidis G, Lee SS, Flisiak R, Kaita K, Manns M, Kotzev I, Tchernev K, Buggisch P, Weilert F, Kurdas OO, Shiffman ML, Trinh H, Gurel S, Snow-Lampart A, Borroto-Esoda K, Mondou E, Anderson J, Sorbel J, Rousseau F.
Gastroenterology. 2010 Oct 15. [Epub ahead of print]
Rating & Commentary
** Important 3-year follow-up of a randomized controlled study which compared the efficacy of TDF vs. ADV. Both patients treated with TDF from the start and patients who switched to TDF after 48 weeks of ADV monotherapy, demonstrated approximately 70% and 90% HBV DNA < 400 copies/mL in HBeAg-positive and –negative hepatitis B, respectively. No resistance was observed.
Acute hepatitis B infection associated with drug-resistant hepatitis B virus.
Xu Z, Liu Y, Xu T, Chen L, Si L, Wang Y, Ren X, Zhong Y, Zhao J, Xu D.
J Clin Virol. 2010 Aug;48:270-4.
Rating & Commentary
* Cross-sectional study of 101 patients with acute hepatitis B. 7% of cases were caused by HBV strains with drug-resistant mutations.
Evolution of hepatitis B genotype C viral quasi-species during hepatitis B e antigen seroconversion.
Wu S, Imazeki F, Kurbanov F, Fukai K, Arai M, Kanda T, Yonemitsu Y, Tanaka Y, Mizokami M, Yokosuka O.
J Hepatol. 2010 Aug 25. [Epub ahead of print]
Rating & Commentary
* Confirmation of earlier studies that HBeAg-seroconversion results in greater diversity of the viral-quasispecies, probably related to escape mutants resulting from stronger selection pressure.
Marcellin P, Cadranel JF, Fontanges T, Poynard T, Pol S, Trepo C, Blin P, Bregman B, Schmidely N, Roudot-Thoraval F, Zarski JP.
Eur J Gastroenterol Hepatol. 2010 Nov;22:1290-6.
Rating & Commentary
* Descriptive, multicenter, retrospective study in 1730 patients (54 centers), describing the types of therapy used in chronic hepatitis B (CHB) in France and patient characteristics according to therapy.
Ribeiro RM, Germanidis G, Powers KA, Pellegrin B, Nikolaidis P, Perelson AS, Pawlotsky JM.
J Infect Dis. 2010 Nov;202:1309-18.
Rating & Commentary
* A meta-analysis of all published studies of viral kinetics in HBeAg-positive and HBeAg-negative infection coupled to an analysis of viral kinetics in 50 HBeAg-negative patients under various treatment protocols with interferon α and/or nucleoside or nucleotide analogs. The dual pole played by the immune response in maintaining low viral levels and inducing a fast turnover of infected cells is revealed.
Juday T, Tang H, Harris M, Powers AZ, Kim E, Hanna GJ.
J Gen Intern Med. 2010 Oct 27. [Epub ahead of print]
Rating & Commentary
* This retrospective cohort study in 1168 CHB patients found that adherence to treatment guideline-recommended monitoring of chronic hepatitis B patients not receiving antiviral treatment, is below guideline recommendations, suggesting that initiation of antiviral therapy may also be delayed, leaving patients at risk for disease progression.
Chun J, Kim W, Kim BG, Lee KL, Suh KS, Yi NJ, Park KU, Kim YJ, Yoon JH, Lee HS.
Am J Transplant. 2010 Jul;10:1649-59.
Rating & Commentary
* Cohort study of 209 patients positive for hepatitis B surface antigen who underwent OLT, who received either combination prophylaxis with HBIG and LAM (89.0%) or HBIG monoprophylaxis (11.0%). Posttransplant HBV recurrence occurred in 22 patients (10.5%), including 13 patients with drug-resistant mutations, after a median follow-up of three years. Recurrent HCC, high viremia at OLT and prolonged exposure to LAM were the main predictors of HBV recurrence.
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