2.Treatment Strategy for Chronic Hepatitis B Virus Infection with Normal Alanine Aminotransferase
Chinese Journal of Gastroenterology 2016;21(2):65-68
Different subtypes of chronic hepatitis B virus(HBV)infection occurred clinically because of the status of virus’s interaction with immune system. In patients with immune tolerance,high level of HBV DNA was found,serum hepatitis B e antigen(HBeAg)was positive,and serum level of alanine aminotransferase(ALT)was normal with only mild or no inflammation in liver tissue. However,not all the patients with normal ALT were in immune tolerance status,the disease could progress insidiously and develop into liver cirrhosis. Whether these patients need anti-viral therapy has always been a hotspot of study. This article reviewed the correlation between immune status and HBV infection,the identification of patients with normal ALT but not in immune tolerance status,and the indication of anti-viral therapy for these patients.
3.Re-understanding of refractory hepatitis C:progress in antiviral therapy strategies for hepatitis C
Journal of Clinical Hepatology 2014;30(6):485-488
It has been nearly 20 years from the discovery of hepatitis C virus (HCV)and clinical diagnosis of hepatitis C to antiviral therapy with interferon,and significant progress has been made.Substantial changes have taken place in both the concept and strategy for antiviral treatment of hepatitis C,with more and more direct-acting antiviral agents emerging in recent years;these changes are as follows:from the control of HCV to clinical cure,from a sustained virologic response (SVR)rate around 30%with conventional interferon therapy to an SVR rate of 70%-80% with standard therapy with pegylated interferon and ribavirin,and from evaluating the difficulty of treatment based on genotypes and viral load to determining the treatment strategy according to host IL28B genotypes and response patterns (rapid virologic re-sponse and complete early virologic response).The progress in antiviral therapy strategies for hepatitis C is systematically reviewed for re-understanding of refractory hepatitis C.
5.Laboratory diagnosis of chronic hepatitis C virus infection
Journal of Clinical Hepatology 2015;31(11):1817-1819
Hepatitis C virus (HCV) is one of the major causes of acute and chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Laboratory diagnosis is essential for the diagnosis of HCV infection. Laboratory etiological diagnosis of chronic HCV infection includes HCV antigen and antibody detection and quantitative detection of HCV RNA. Quantitative detection of serum HCV RNA is the only laboratory diagnosis index for current HCV infection and plays a very important role in determination of treatment time, selection of treatment regimens, and evaluation of therapeutic effect of antiviral treatment. This paper elaborates on the target population, detection methods, and clinical significance in laboratory screening for chronic HCV infection, so as to provide timely diagnosis and effective treatment of chronic HCV infection.
7.Pre-Core mutation of HBV among 26 families with history of chronic HBV infection in Shenyang.
Zhiwei LI ; Xiaoguang DOU ; Pei LIU
Chinese Journal of Experimental and Clinical Virology 2002;16(3):239-241
OBJECTIVETo investigate the Pre-Core mutations of HBV and clinical significance among families with history of chronic HBV infection.
METHODSThe G to A mutation at nucleotide 1896 in the pre C gene of HBV DNA was detected by PCR-RFLP.
RESULTSThe results showed that the mutation rate of G to A mutation at nucleotide 1896 in the pre C gene of HBV DNA was much higher in patients (56.3%) and their family members (40.5%) than in their spouses (25.0%). While the positive rate of anti-HBs in their spouses were 26.3%. On the other hand those mutations were much higher in chronic hepatitis B patients (52.4%) and HBV carriers (44.4%) than in chronic severe hepatitis B patients (20.0%).
CONCLUSIONSThe G to A mutation at nucleotide 1896 in the pre C gene of HBV DNA could be associated with persistent HBV infection.
Adolescent ; Adult ; Child ; China ; epidemiology ; Female ; Genes, Viral ; genetics ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; epidemiology ; virology ; Humans ; Male ; Middle Aged ; Point Mutation ; Polymorphism, Restriction Fragment Length
8.Selection and evaluation of treatment regimens with direct-acting antiviral agents for patients with chronic hepatitis C in the real world in China
Ziying AN ; Yang DING ; Xiaoguang DOU
Journal of Clinical Hepatology 2018;34(2):233-237
Chronic hepatitis C (CHC) is a chronic and progressive disease prevalent in the whole world and greatly threatens human health.The launch of direct-acting antiviral agents (DAAs) brings a revolutionary change in the treatment of CHC.In recent years,several DAAs have been marketed in foreign countries and have achieved good clinical effects,and in China,some DAAs have also been approved and widely used in clinical practice,which contributes to the increase in the cure rate of hepatitis C.This article analyzes the features,clinical effects,and indications of DAAs marketed in China and reviews published real-world studies,in order to help clinicians select proper treatment regimens based on patients' features.
9.Antiviral therapeutic strategies for chronic hepatitis B patients with a normal alanine aminotransferase level
Journal of Clinical Hepatology 2018;34(5):926-929
Alanine aminotransferase (ALT) is one of the most sensitive biochemical parameters used to reflect the degree of liver injury.It is generally believed that patients with hepatitis B virus (HBV) infection and a normal ALT level are in the immune tolerance state,and no antiviral therapy is required in patients without liver inflammation or those with mild liver inflammation.However,these patients are not always in the immune tolerance state,and the disease can insidiously progress to chronic hepatitis B (CHB),liver cirrhosis,and even hepatocellular carcinoma.Therefore,antiviral therapy for CHB patients with normal ALT has always been a hot topic of clinical research.This article elaborates on the association between ALT and liver inflammation in CHB patients and the timing of antiviral therapy for CHB patients with normal ALT.
10. Considerations of using oral nucleos(t)ide analogues to interrupt mother-to-child transmission in HBV carrier pregnant woman with high viral load
Yang DING ; Qiuju SHENG ; Xiaoguang DOU
Chinese Journal of Hepatology 2019;27(2):85-87
The main transmission route of chronic hepatitis B virus infection is mother-to-child transmission of hepatitis B virus and the main cause of combined immune prophylaxis failure in neonates at the end of pregnancy is high viral load. Moreover, oral administration of nucleos(t)ide analogues (NAs) during the second and third trimesters of pregnancy can significantly reduce or even completely block mother-to-child transmission of HBV. This article focuses on the necessity and feasibility of oral NAs antiviral therapy for HBV carrier pregnant woman with high viral load, and the issues commences at the time of medication and viral load thresholds.