Interferon and nucleotide/nucleoside analogues are currently widely used in the management of chronic hepatitis B virus ( HBV) infections, but are facing problems such as poor sustained virologic response, low HBsAg clearance rate and a high risk of recurrence after drug withdraw.Exploring new target of anti-HBV agent has become a hot topic in recent years.This paper reviews the research progress on new anti-HBV targets and related drugs.

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Objective To investigate the association of restriction fragment length polymorphisms (RFLP) in p.S267F of SLC10A1 gene with clinical outcomes of hepatitis B virus (HBV) infection. Methods Clinical data of 1 268 patients with HBV infections admitted in Public Health Clinical Center Affiliated to Fudan University during July 2014 and February 2015 were collected.Polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP) method was used to genotype the p .S267F of SLC10A1 gene in all patients, and the potential association between variants in p .S267F of SLC10A1 gene and the clinical outcomes of HBV infection was analyzed .Results Among 1 268 patients with HBV infections, 1 226 were of genotype CC, and 42 were of genotype CT, so the variation rate in p.S267F was 3.31%(42/1 268).Compared with patients with genotype CC , patients with genotype CT had a higher incidence of acute HBV infections (13.6%vs.28.6%,χ2 =19.819, P<0.05) and a lower incidence of HBV-related liver cirrhosis or hepatocellular carcinoma (13.9% vs.4.8%, χ2 =18.945, P <0.05). Conclusion RFLP in p.S267F of SLC10A1 gene may be associated with chronicity and aggravation of HBV infection, and genotype CT is possibly a protective factor .

The hepatocellular carcinoma (HCC) diagnosed by serum biomarkers is usually at late stages, and the five-year survival rate of HCC is extremely low. Therefore, it is necessary to develop an efficient and noninvasive biomarker that can detect HCC at an early stage and to explore a new strategy for the treatment of HCC. Abundant evidence has shown that microRNAs(miRNA)s is involved in the development and progression of HCC, and it can be a sensitive biomarker for the detection of HCC and a new target for the treatment of HCC. The article introduces the application of miRNAs in the diagnosis and treatment of HCC, and believes that the diagnosis and treatment strategy for HCC based on miRNAs has great potential in clinical application, yet remains to be studied.

Non-alcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease in developed countries. The obvious association between NAFLD and cardiovascular disease (CVD) has been proved by a series of retrospective and prospective studies in recent years. It is indicated that NAFLD could result in CVD by increasing carotid intima thickness and arterial wall stiffness and causing endothelial dysfunction, coronary artery calcification, left ventricular remodeling, and left ventricular diastolic dysfunction. As an independent risk factor, NAFLD could promote the development and progression of CVD, which, correspondingly, is the main cause of death in NAFLD patients. Therefore, risk assessment for CVD in NAFLD patients is so important that the disease progression could be delayed by lifestyle modification and pharmacotherapy. Then the mortality related to CVD may be reduced and the overall prognosis of NAFLD patients would be improved.

Non-alcoholic fatty liver disease (NAFLD) affects up to a third of the population in developed countries. Between 10% and 30% of patients with NAFLD have non-alcoholic steatohepatitis (NASH). There are metabolic risk factors common to both NAFLD and cardiovascular disease, so patients with NASH have an increased risk of liver-related and cardiovascular death. This articles reviews the most recent advances in the management of NAFLD in five main areas: lifestyle modification, weight loss treatment, therapy for metabolic syndrome, insulin sensitizer and antioxidant pharmacotherapy, and management of end-stage liver disease. It is pointed out that clinicians need to pay more attention to metabolic syndrome in the diagnosis and treatment of NAFLD.

Chronic infection with hepatitis B virus (HBV) often leads to the development of liver cirrhosis and liver cancer, creating immense sociological, clinical, and economic burdens worldwide. Although current anti-HBV drugs can control the disease progression, they often fail to eliminate the virus because of the presence of covalently closed circular DNA (cccDNA) in the hepatocyte nucleus. We review the research advances in therapeutic strategies against cccDNA from the aspects of interfering with cccDNA synthesis, promoting cccDNA degradation, and silencing cccDNA. Targeting cccDNA is a promising approach that may lead to a cure of chronic HBV infection.

ObjectiveTo investigate the clinical features of acute hepatitis B (AHB) and acute exacerbation of chronic hepatitis B (CHB) for differential diagnosis. MethodsA retrospective analysis was performed on the clinical data of 96 AHB patients and 124 patients with acute exacerbation of CHB, who were admitted to the Public Health Clinical Center Affiliated to Fudan University from June to December, 2014. Comparison of continuous data between the two groups was made by Mann Whitney U test, while comparison of categorical data was made by chi-square test. ResultsThere were no significant differences in the age of onset and sex between the AHB group and the acute exacerbation of CHB group; the incidence was higher in males than in females. Sexual transmission and iatrogenic transmission were the main routes of transmission for AHB, while mother-to-child transmission was the main route of transmission for acute exacerbation of CHB. The sensitivity and specificity of alanine aminotransferase (ALT) level ≥1072 U/L for diagnosing AHB were 78.6% and 79.2%, respectively. The sensitivity and specificity of S/CO ≥13.6 in the anti-HBc-IgM test for diagnosing AHB were 94.5% and 89.3%, respectively. At week 2 after admission, the AHB group showed significantly greater decreases in levels of HBsAg, HBeAg, and hepatitis B virus (HBV) DNA than the acute exacerbation of CHB group (P＜0.05). At week 8 after admission, the AHB group had significantly higher HBsAg clearance rate, anti-HBs seroconversion rate, HBeAg clearance rate, anti-HBe seroconversion rate, and HBV DNA clearance rate than the acute exacerbation of CHB group (P＜0.05). ConclusionIt is helpful for making the differential diagnosis between AHB and acute exacerbation of CHB to know the route of transmission, ALT level, anti-HBc-IgM test result (S/CO value), HBV DNA clearance rate, and the seroconversion rates of HBV markers.