Antiviral Agents ; therapeutic use ; Female ; Hepatitis B virus ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications ; drug therapy ; virology

Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; virology

Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; virology

Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; complications ; drug therapy ; virology ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; drug therapy

Occult HBV infection is defined as the presence of HBV DNA in the liver (with or without detectable or undetectable HBV DNA in the serum) of individuals testing negative for HBsAg. Studies on occult HBV infection in hepatitis C patients have reported highly variable prevalence, because the prevalence of occult HBV infection varies depending on the hepatitis B risk factors and methodological approaches. The most reliable diagnostic approach for detecting occult HBV detection is through examination of liver DNA extracts. HCV has been suspected to strongly suppress HBV replication up to the point where it may be directly responsible for occult HBV infection development. However, more data are needed to arrive at a definitive conclusion regarding the role of HCV in inducing occult HBV infection. Occult HBV infection in chronic hepatitis C patients is a complex biological entity with possible relevant clinical implications. Influence of occult HBV infection on the clinical outcomes of chronic hepatitis C may be considered negative. However, recent studies have shown that occult HBV infection could be associated with the development of hepatocellular carcinoma and contribute to the worsening of the course of chronic liver disease over time in chronic hepatitis C patients. Nevertheless, the possible role of occult HBV infection in chronic hepatitis C is still unresolved and no firm conclusion has been made up until now. It still remains unclear how occult HBV infection affects the treatment of chronic hepatitis C. Therefore, in order to resolve current controversies and understand the pathogenic role and clinical impacts of occult HBV infection in chronic hepatitis C patients, well-designed clinical studies are needed.
Carcinoma, Hepatocellular/complications ; DNA, Viral/analysis ; Hepacivirus/genetics ; Hepatitis B/*complications/*diagnosis/drug therapy ; Hepatitis B virus/genetics ; Hepatitis C, Chronic/*complications/*diagnosis/drug therapy ; Humans ; Interferon-alpha/therapeutic use ; Liver/virology ; Liver Neoplasms/complications

Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Hepatitis B, Chronic ; complications ; drug therapy ; virology ; Humans ; Lamivudine ; adverse effects ; therapeutic use ; Liver Cirrhosis ; drug therapy ; virology

Amino Acid Motifs ; genetics ; Female ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; complications ; drug therapy ; virology ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; drug therapy ; etiology ; virology ; Male ; Point Mutation ; RNA-Directed DNA Polymerase ; genetics ; Reverse Transcriptase Inhibitors ; therapeutic use

Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis B, Chronic ; complications ; virology ; Humans ; Integrative Medicine ; Liver Cirrhosis ; drug therapy ; etiology

<b>OBJECTIVEb>To evaluate the effects of antiviral nucleotide/nucleoside analogues (NUCs) and interferon (IFN) on liver fibrosis and progression to cirrhosis in patients with hepatitis B virus (HBV) infection.

<b>METHODSb>The literature databases of PubMed (1966 to 2011), Embase (1966 to 2011), Wanfang database (1998 to 2011), Chinese National Knowledge Infrastructure (CNKI; 1997 to 2010), and Chinese Biomedical (CBMdisc; 1860 to 2011) were searched for studies that met the following criteria: (1) case-control phase III clinical trails that used only one kind of antiviral drug (NUCs or IFN), with the controls receiving placebo or no treatment; (2) analysis of biopsy specimens collected before and after treatment for both the cases and controls; (3) assessment of fibrosis as an outcome measure of the treatment's effect. The data from all 11 studies included in the meta-analysis were extracted and analyzed by the RevMan5.1 software.

<b>RESULTSb>NUC treatment significantly regressed liver fibrosis, as compared with placebo treatment (33.7% vs. 19.2%, relative risk (RR): 1.82, 95% confidence interval (CI): [1.47, 2.25], P less than 0.01). NUC treatment significantly reduced the progression of fibrosis, as compared with placebo treatment (9.1% vs. 24.8%, RR: 0.33, 95% CI: [0.19, 0.58], P less than 0.01). IFN treatment significantly reduced progression of fibrosis, as compared with no treatment (23.8% vs. 30.7%, RR: 0.48, 95% CI: [0.34, 0.69], P less than 0.01). IFN significantly reduced progression to cirrhosis, as compared with no treatment (10.6% vs. 18.0%, RR: 0.62, 95% CI: [0.44, 0.88], P less than 0.01).

<b>CONCLUSIONb>One year of NUC treatment could partly regress liver fibrosis and partly reduce the progression of fibrosis, while one year of IFN treatment could reduce the progression of fibrosis and cirrhosis.

Antiviral Agents ; pharmacology ; therapeutic use ; Clinical Trials, Phase III as Topic ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; virology

<b>OBJECTIVEb>To analyze the development of liver damage and reactivation of hepatitis B virus (HBV) during the treatment of extremely severe burn injury in HBsAg positive patients, in order to provide reference for prevention and treatment of liver damage in patients with HBV infection after extremely severe burn.

<b>METHODSb>Medical records of 54 HBsAg positive patients after extremely severe burn injury admitted from January 2004 to December 2014 were retrospectively analyzed. Development of liver damage and HBV reactivation of these patients during the treatment were analyzed according to the classification of their gender, results of hepatitis B e antigen (HBeAg) and HBV DNA examinations on admission, and development of sepsis in the process of treatment. Data were processed with chi-square test.

<b>RESULTSb>(1) The incidence of liver damage in the process of treatment of these patients was 85.2% (46/54). Among all the patients, the proportion of liver damage was 35/38 in male, which was significantly higher than that in female (11/16, χ² = 4.867, P<0.05). Liver damage was found in all of 26 patients who were HBeAg positive on admission, 34 patients who were HBV DNA positive on admission, and 36 patients who developed sepsis in the process of treatment; the proportions were significantly higher than those in patients who were HBeAg negative on admission (20/28), patients who were HBV DNA negative on admission (12/20), and patients who did not develop sepsis in the process of treatment (10/18), with χ² values respectively 11.801, 18.384, and 20.574, P values below 0.01. (2) The incidence of HBV reactivation in these patients was 29.6% (16/54). Among all the patients, the proportion of HBV reactivation was 13/38 in male and 3/16 in female, with no statistically significant difference between them (χ² = 0.656, P>0.05). The proportions of HBV reactivation in patients who were HBeAg positive on admission, patients who were HBV DNA positive on admission, and patients who developed sepsis in the process of treatment were respectively 13/26, 16/34, and 15/36, and they were significantly higher than those in patients who were HBeAg negative on admission (3/28), patients who were HBV DNA negative on admission (0/20), and patients who did not develop sepsis in the process of treatment (1/18), with χ² values respectively 9.979, 18.615, and 5.873, P<0.05 or P<0.01.

<b>CONCLUSIONSb>Patients who are HBsAg positive, HBeAg positive, HBV DNA positive on admission, and develop sepsis in the process of treatment of extremely severe burn injury are more likely to develop liver damage and HBV reactivation. It is necessary to dynamically monitor the changes in HBV DNA and liver function, in order to identity the reactivation of virus.

Alanine Transaminase ; blood ; Burns ; complications ; drug therapy ; Chemical and Drug Induced Liver Injury ; DNA, Viral ; Female ; Hepatitis Antibodies ; blood ; Hepatitis B ; drug therapy ; epidemiology ; virology ; Hepatitis B Surface Antigens ; blood ; immunology ; Hepatitis B virus ; drug effects ; immunology ; isolation & purification ; Hepatitis B, Chronic ; blood ; pathology ; virology ; Humans ; Incidence ; Liver ; pathology ; Male ; Retrospective Studies