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| 1 | Update on hepatitis B virus infection显示文摘Chronic infection with hepatitis B virus(HBV) leads to the development of hepatocellular carcinoma and/or chronic liver failure. Despite extensive research, the immunopathogenesis is not completely understood. Viral persistence and clinical outcomes following HBV infection depend on viral factors and host factors; including genetic factors that determine a host's immune mechanisms. The primary goal of chronic hepatitis B(CHB)treatment is to eradicate HBV or to at least maintain suppression of HBV replication. Despite recent advances in anti-viral agents for chronic HBV infection, complete eradication of the virus has been difficult to achieve.Agents for the treatment of CHB are divided mainly into two groups: immunomodulating agents and antiviral nucleos(t)ide analogues(NAs). Although NAs are safe,effective and easily administered orally, their long-term use poses the risk of drug resistance. Currently, international evidence-based guidelines have been developed to support physicians in managing CHB patients.However, treatment of patients with drug resistance is still challenging, as only a few classes of anti-HBV drugs are available and cross-resistance between drugs can occur. In addition, as the currently available genotypictest for detection of drug resistance still has limitations in identifying the different substitutions present in the same viral genome, the development of a new virologic test to overcome this limitation is necessary. Among the predictive factors associated with response to pegylated interferon(PEG-IFN) therapy, hepatitis B surface antigen quantification is considered to be a surrogate marker for monitoring response to PEG-IFN. Current practice guidelines stress the importance of profound and durable HBV viral suppression in the treatment of CHB patients. To this end, it is essential to choose a potent antiviral drug with a low risk of resistance for initial treatment of CHB to achieve sustained virological response. This review highlights recent advances in the understanding of the immunopathogenesis of HBV and currently available and developing treatment strategies against HBV infection. | Chan Ran You Sung Won Lee Jeong Won Jang Seung Kew Yoon | 2014 | World Journal of Gastroenterology2014，20，37： | 7 |
| 2 | Serum hepatitis B surface antigen levels predict treatment response to nucleos(t)ide analogues显示文摘Quantification of hepatitis B surface antigen(HBsAg)has been suggested to be helpful in the management of chronic hepatitis B(CHB)patients.Nucleos(t)ide analogs(NAs)are the therapy of choice for CHB and are used in the majority of CHB patients.NAs are able to induce hepatitis B virus(HBV)viral suppression,normalization of alanine aminotransferase(ALT)levels,and improvement in liver histology.Automated quantitative assays for serum HBsAg have recently become available,facilitating standardized quantification of serum HBsAg.This has led to increased interest in the clinical application of quantitative serum HBsAg for predicting therapeutic response to NAs.Recent studies have shown that a decline in serum HBsAg levels in patients receiving peginterferon may signal successful induction of immune control over HBV,and can therefore be used to predict therapeutic response.NA treatment typically induces a less rapid decline in HBsAg than interferon treatment;it has been estimated that full HBsAg clearance can require decades of NA treatment.However,a rapid HBsAg decline during NA therapy may identify patients who will show clearance of HBsAg.Currently,there is no consensus on the clinical utility of serum HBsAg monitoring for evaluating patient responses to NA therapy.This review focuses on recent findings regarding the potential application of HBsAg quantification in the management of CHB patients receiving NA therapy. | Chien-Hung Chen Yi-Chun Chiu Sheng-Nan Lu Chuan-Mo Lee Jing-Houng Wang Tsung-Hui Hu Chao-Hung Hung | 2014 | World Journal of Gastroenterology2014，20，24： | 6 |
| 3 | Treatment of chronic hepatitis B in clinical practice with entecavir or tenofovir显示文摘Results from phaseⅢclinical trials clearly demonstrate the efficacy and safety of entecavir and tenofovir in the controlled environment of randomized clinical studies.There are several studies with both drugs performed in clinical practice(also called'real life studies').Despite the pros and cons,studies performed in real life conditions represent everyday practice and add important information about long term treatment effectiveness and safety in this clinical setting.This review shows that patients treated with first line nucleos(t)ide analogs at referral centres,with good clinical follow-up and adherence to international guidelines,can achieve high treatment response rates with a very low rate of adverse events. | Ezequiel Ridruejo | 2014 | World Journal of Gastroenterology2014，20，23： | 4 |
| 4 | Baseline HBsAg predicts response to pegylated interferon-α2b in HBeAg-positive chronic hepatitis B patients显示文摘AIM: To evaluate the predictive effect of baseline hepatitis B surface antigen(HBsAg) on response to pegylated interferon(PEG-IFN)-α2b in hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB) patients.METHODS: This retrospective analysis compared the treatment efficacy of PEG-IFN-α2b alone in 55 HBeAgpositive CHB patients with different baseline HBsAg levels. Serum HBV DNA load was measured at baseline, and at 12, 24 and 48 wk of therapy. Virological response was defined as HBV DNA < 1000 IU/mL. Serum HBsAg titers were quantitatively assayed at baseline, and at 12 and 24 wk.RESULTS: Eighteen patients had baseline HBsAg > 20 000 IU/mL, 26 patients had 1500-20000 IU/mL, and 11 patients had < 1500 IU/mL. Three(16.7%), 11(42.3%) and seven(63.6%) patients in each groupachieved a virological response at week 48, with a significant difference between groups with baseline HBsAg levels > 20000 or < 20000 IU/mL(P = 0.02). Thirteen patients had an HBsAg decline > 0.5 log10 and 30 patients < 0.5 log10 at week 12; and 6(46.2%) and 10(33.3%) in each group achieved virological response at week 48, with no significant difference between the two groups(P = 0.502). Eighteen patients had an HBsAg decline > 1.0 log10 and 30 patients < 1.0 log10 at week 24, and 8(44.4%) and 11(36.7%) achieved a virological response at week 48, with no significant difference between the two groups(P = 0.762). None of the 16 patients with HBsAg > 20000 IU/mL at week 24 achieved a virological response at week 48.CONCLUSION: Baseline HBsAg level in combination with HBV DNA may become an effective predictor for guiding optimal therapy with PEG-IFN-α2b against HBeAg-positive CHB. | Gong-Ying Chen Meng-Fei Zhu Da-Liang Zheng Yan-Ting Bao Jie Wang Xiang Zhou Guo-Qiang Lou | 2014 | World Journal of Gastroenterology2014，20，25： | 4 |
| 5 | 肝移植术后乙型肝炎复发的预防及治疗新进展显示文摘我国是乙型病毒性肝炎的高发国家,由于肝移植技术的开展及术后有效预防措施,使得越来越多的乙肝相关性肝病患者重获新生。在开展肝移植早期,由于缺乏有效的预防措施,术后乙肝复发率高达80%以上。乙肝免疫球蛋白(HBIG)联合核苷(酸)类似物治疗,可使肝移植术后乙肝复发率降低至10%以下[1]。既往一种核苷(酸)类似物联合HBIG治疗是肝移植术后预防乙肝复发公认最好的方案,但是长期使用HBIG不方便。 | 章拔翠 陈虹 | 2015 | 实用器官移植电子杂志2015，3，3： | 2 |
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