1.Antiviral treatment of chronic hepatitis B patients with renal insufficiency
Jueqing GU ; Hongyu JIA ; Xiaoli ZHANG ; Chanyuan YE ; Yida YANG
Chinese Journal of Clinical Infectious Diseases 2020;13(1):75-80
Chronic hepatitis B (CHB) is an infectious disease characterized by liver damage, which can progress to liver fibrosis, cirrhosis, liver failure or liver cancer, threatening the life of patients. CHB patients are prone to be complicated with hepatitis B virus-associated glomerulonephritis and other kidney diseases, therefore the renal safety should be fully considered in the antiviral treatment of CHB patients. According to current guidelines, telbivudine, entecavir or tenofovir alafenamide are recommended for CHB patients with renal insufficiency or potential renal injury, but each has its advantages and disadvantages. How to carry out antiviral treatment in CHB patients with renal impairment deserves our attention. At the same time, the renal function should be monitored regularly in the course of antiviral treatment to identify the damage of renal function in the early stage. This article reviews the causes of renal dysfunction in CHB patients, the risk of kidney damage during the antiviral treatment, the choices of antiviral therapy and the monitoring of renal function in the patients.
2.Research progress on interferon λ in chronic hepatitis B
Chanyuan YE ; Shanyan ZHANG ; Xiaoli ZHANG ; Jueqing GU ; Yida YANG
Chinese Journal of Clinical Infectious Diseases 2020;13(3):228-233
Hepatitis B is a major public health problem in China. Nucleoside/nucleotide analogues and interferon(IFN) can effectively inhibit the replication of hepatitis B virus, but the treatment effect is still not so effective because cccDNA cannot be completely removed. IFNλ is a newly discovered family of cytokines that induces antiviral, antiproliferative and antitumor effects by activating the Jak-STAT pathway. Recent studies have found that IFNλ is also of great significance in hepatitis B as a therapeutic agent and immunological indicator. IFNλ can effectively inhibit the replication of hepatitis B virus, while the gene polymorphisms of IFNλ are closely related to prognosis and susceptibility to hepatitis B; and IFNλ also shows a certain anti-tumor activity in hepatitis B-related hepatocellular carcinoma. IFNλ is expected to be used as a clinical adjuvant treatment for patients with hepatitis B. This article describes the current research progress on IFNλ in hepatitis B.