7.Low-level viremia in nucleoside analog-treated chronic hepatitis B patients.
Qian ZHANG ; Da-Chuan CAI ; Peng HU ; Hong REN
Chinese Medical Journal 2021;134(23):2810-2817
Low-level viremia (LLV) was defined as persistent or intermittent episodes of detectable hepatitis B virus (HBV) DNA (<2000 IU/mL, detection limit of 10 IU/mL) after 48 weeks of antiviral treatment. Effective antiviral therapies for chronic hepatitis B (CHB) patients, such as entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF), have been shown to inhibit the replication of HBV DNA and prevent liver-related complications. However, even with long-term antiviral therapy, there are still a number of patients with persistent or intermittent LLV. At present, the research on LLV to address whether adversely affect the clinical outcome is limited, and the follow-up treatment for these patients is open to question. At the same time, the mechanism of LLV is not clear. In this review, we summarize the incidence of LLV, the association between LLV and long-term outcomes, possible mechanisms, and management strategies in these patient populations.
Antiviral Agents/therapeutic use*
;
DNA, Viral
;
Hepatitis B virus/genetics*
;
Hepatitis B, Chronic/drug therapy*
;
Humans
;
Nucleosides/therapeutic use*
;
Tenofovir/therapeutic use*
;
Treatment Outcome
;
Viremia/drug therapy*
8.To evaluate treatments of chronic hepatitis B.
Chinese Journal of Hepatology 2006;14(6):402-405
9.Effect of different therapeutic regimens on serum interleukin-21 levels in patients with chronic hepatitis B.
Min ZOU ; Minmin LI ; Xiaojuan LI ; Yuanping ZHOU ; Shuwen LIU
Journal of Southern Medical University 2012;32(9):1284-1286
OBJECTIVETo detect serum interleukin-21 (IL-21) levels in patients with chronic hepatitis B receiving different therapeutic regimens.
METHODSA total of 198 patients with inactive chronic hepatitis B were divided into 3 groups according to the therapeutic regimens, namely interferon (IFN)-treated group (IFN group, n∓38), nucleoside analogue-treated group (NA group, n∓72) and untreated group (control group, n∓88). IL-21 and serum hepatitis B virus (HBV) markers were detected in these patients using enzyme-linked immunosorbent assay (ELISA), and the liver function indices were measured with an auto-biochemical analyzer.
RESULTSThe serum IL-21 levels in Con and IFN groups were significantly higher than those in NA group (102.29∓14.03, 123.01∓38.26, and 48.10∓7.06 pg/ml, respectively, P<0.05). When all the patients were regrouped according to the status of HBeAg, serum IL-21 level was 114.83∓19.88 pg/ml in HBeAg-negative group (n∓105), significantly higher than that of 61.53∓6.61 pg/ml in HBeAg-positive group (n∓93) (P<0.05). Bivariate correlation analysis showed no significant correlations between IL-21 and liver function indices.
CONCLUSIONThe immunomodulator IFN might be capable of increasing serum IL-21 levels, while nucleoside analogues can decrease IL-21 level in patients with chronic hepatitis B. HBeAg-negative patients have a significantly higher serum IL-21 level, suggesting that the expression of HBeAg might result in IL-21 depression.
Adult ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Interferons ; therapeutic use ; Interleukins ; blood ; Male ; Nucleosides ; therapeutic use
10.The degree of HBV suppression with 24 week telbivudine- or lamivudine-treatment in hepatitis B patients predicts the efficacy of the treatment at week 52.
Ji-dong JIA ; Jin-lin HOU ; You-kuan YIN ; Dao-zhen XU ; De-ming TAN ; Jun-qi NIU ; Xia-qiu ZHOU ; Yu-ming WANG ; Li-min ZHU ; Yong-wen HE ; Hong REN ; Mo-bin WAN ; Cheng-wei CHEN ; Shan-ming WU ; Ya-gang CHEN ; Jia-zhang XU ; Qin-huan WANG ; Lai WEI ; Hong MA
Chinese Journal of Hepatology 2007;15(5):342-345
OBJECTIVESTo investigate the possibilities of an association between the degrees of HBV suppression with nucleoside treatments at week 24 and week 52 in hepatitis B patients and to find a useful predictor for treatment efficacy.
METHODSIn this phase III, double-blind, multicenter trial, we compared the efficacy of telbivudine treatment with lamivudine treatment in 332 Chinese compensated chronic hepatitis B patients. The patients were randomly assigned to a daily 600 mg telbivudine treatment group or daily 100 mg lamivudine group for 24 weeks. They were then categorized into 4 groups according to their serum HBV DNA levels (copies/ml) at week 24: a PCR-undetectable group (< 300 copies/ml); a QL- < 10(3) copies/ml group; a 10(3)-<10(4) copies/ml group; and a > or = 10(4) copies/ml group. The treatments were continued as they previously had been for another 28 weeks and the patients serum HBV DNA levels were examined again.
RESULTSAt week 52, mean reductions of serum HBV DNA were significantly greater in the telbivudine-treated patients than in the lamivudine-treated group (6.2 log10 vs 5.4 log10, t = 3.6, P < 0.01). Viral resistance was twice as common in lamivudine-treated patients compared to those receiving telbivudine. Telbivudine was well-tolerated with an adverse event profile similar to that of lamivudine. The lower the HBV DNA level achieved at week 24, the higher HBV DNA non-detectable by PCR. ALT normalization and HBeAg seroconversion achieved at week 52, and viral resistance at week 48 decreased parallel to the degree of HBV DNA inhibition.
CONCLUSIONHBV DNA PCR-undetectable at week 24 in nucleoside-treated hepatitis B patients suggests a better efficacy at week 52 and lower viral resistance at week 48. The degree of suppression of HBV at week 24 may be used as a predictor of 1-year outcome.
Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Double-Blind Method ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Nucleosides ; therapeutic use ; Pyrimidinones ; therapeutic use ; Thymidine ; analogs & derivatives ; Treatment Outcome ; Young Adult
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