BACKGROUND/AIMS: This study investigated the antiviral effects of tenofovir disoproxil fumarate (TDF) monotherapy in nucleos(t)ide analogue (NA)-naive and NA-experienced chronic hepatitis B (CHB) patients. METHODS: CHB patients treated with TDF monotherapy (300 mg/day) for > or =12 weeks between December 2012 and July 2014 at a single center were retrospectively enrolled. Clinical, biochemical, and virological parameters were assessed every 12 weeks. RESULTS: In total, 136 patients (median age 49 years, 96 males, 94 HBeAg positive, and 51 with liver cirrhosis) were included. Sixty-two patients were nucleos(t)ide (NA)-naive, and 74 patients had prior NA therapy (NA-exp group), and 31 patients in the NA-exp group had lamivudine (LAM)-resistance (LAM-R group). The baseline serum hepatitis B virus (HBV) DNA level was 4.9+/-2.3 log IU/mL (mean+/-SD), and was higher in the NA-naive group than in the NA-exp and LAM-R groups (5.9+/-2.0 log IU/mL vs 3.9+/-2.0 log IU/mL vs 4.2+/-1.7 log IU/mL, P<0.01). The complete virological response (CVR) rate at week 48 in the NA-naive group (71.4%) did not differ significantly from those in the NA-exp (71.3%) and LAM-R (66.1%) groups. In multivariate analysis, baseline serum HBV DNA was the only predictive factor for a CVR at week 48 (hazard ratio, 0.809; 95% confidence interval, 0.729-0.898), while the CVR rate did not differ with the NA experience. CONCLUSIONS: TDF monotherapy was effective for CHB treatment irrespective of prior NA treatment or LAM resistance. Baseline serum HBV DNA was the independent predictive factor for a CVR.
Adult ; Aged ; Aged, 80 and over ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Drug Resistance, Viral ; Female ; Hepatitis B e Antigens/blood ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/complications/*drug therapy ; Humans ; Lamivudine/therapeutic use ; Liver Cirrhosis/etiology ; Male ; Middle Aged ; Nucleotides/*chemistry/therapeutic use ; Retrospective Studies ; Tenofovir/*therapeutic use ; Treatment Outcome

BACKGROUND/AIMS: Tenofovir disoproxil fumarate (TDF) plays a pivotal role in the management of drug-resistant chronic hepatitis B. However, it remains unclear whether TDF-nucleoside analogue combination therapy provides better outcomes than TDF monotherapy. This study aimed to compare the efficacy of TDF monotherapy with that of TDF-nucleoside analogue combination therapy in patients with drug-resistant chronic hepatitis B. METHODS: This retrospective cohort study included 76 patients receiving TDF-based rescue therapy for more than 12 months. Suboptimal response was defined as serum HBV-DNA level of >60 IU/mL during prior rescue therapy. Multi-drug resistance was defined as the presence of two or more drug resistance-related mutations confirmed by mutation detection assay. The relationship between baseline characteristics and virologic response (HBV DNA <20 IU/mL) at 12 months were evaluated using logistic regression analysis. RESULTS: Fifty-five patients (72.4%) were suboptimal responders to prior rescue therapy, and 26 (34.2%) had multi-drug resistance. Forty-two patients (55.3%) received combination therapy with nucleoside analogues. Virologic response at 12 months was not significantly different between the TDF monotherapy group and TDF-nucleoside analogue combination therapy group (p=0.098). The serum HBV DNA level was reduced to -4.49+/-1.67 log10 IU/mL in the TDF monotherapy group and to -3.97+/-1.69 log10 IU/mL in the TDF-nucleoside analogue combination therapy group at 12 months (p=0.18). In multivariate analysis, female sex (p=0.032), low baseline HBV-DNA level (p=0.013), and TDF monotherapy (p=0.046) were predictive factors for virologic response at 12 months. CONCLUSIONS: TDF monotherapy showed similar efficacy to that of TDF-nucleoside analogue combination therapy in patients with drug-resistant chronic hepatitis B.
Adult ; Aged ; Antiviral Agents/pharmacology/*therapeutic use ; Cohort Studies ; DNA, Viral/blood ; Drug Resistance, Viral ; Drug Therapy, Combination ; Female ; Hepatitis B virus/drug effects/genetics/isolation & purification ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Nucleosides/chemistry/therapeutic use ; Retrospective Studies ; Sex Factors ; Tenofovir/*therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVECell-free DNA (cfDNA) was shown to be a prognostic marker for diverse pathological states in the Intense Care Unit, but little is known of the role of cfDNA in HBV-related acute-on-chronic liver failure (ACLF). We hypothesize that cfDNA can also be a promising prognostic as well as a diagnostic marker in patients with HBV-related ACLF.

METHODSThirty-eight patients with HBV-related ACLF admitted in the Intense Care Unit were enrolled in the study. The patients were divided, according to the improvement of liver function at discharge, into favorable prognosis group (group 1, n=17) and poor prognosis group (group 2, n=19). Plasma samples were collected from each patient at hospitalization and at discharge to measure cfDNA by real-time quantitative PCR. MELD score was calculated at the same time points.

RESULTSThe average level of cfDNA of group 1 was lower than that of group 2 both at the time of hospitalization (P=0.044) and at discharge (P<0.001). There was no difference in MELD score between the two groups at hospitalization. Significant correlations were found of cfDNA levels with the MELD score, TBIL, CRE and INR both at hospitalization (γ=0.662, P<0.001; γ=0.356, P=0.033; γ=0.360, P=0.031; γ=0.570, P<0.001, respectively) and at discharge (γ=0.854, P<0.001; γ=0.821, P<0.001; γ=0.650, P<0.001; γ=0.638, P<0.001, respectively). The ROC curve showed that cfDNA level at discharge was optimal in diagnosing ACLF with an area under curve (AUC) value of 0.96, followed by δcfDNA (AUC value of 0.923) and cfDNA level at hospitalization (AUC value of 0.667). The MELD scores had an AUC value of only 0.545 at the time of hospitalization.

CONCLUSIONcfDNA may serve as a promising prognostic and diagnostic marker for predicting in-hospital prognosis of HBV-related ACLF within 2 to 8 weeks.

Acute-On-Chronic Liver Failure ; diagnosis ; virology ; Adult ; DNA, Viral ; blood ; End Stage Liver Disease ; diagnosis ; Female ; Hepatitis B ; complications ; Hepatitis B virus ; genetics ; Humans ; Male ; Middle Aged ; Pilot Projects ; Plasma ; chemistry ; Prognosis ; Severity of Illness Index

OBJECTIVETo observe the change in the number of antibodies of preneoplastic hepatocellular carcinoma (HCC) using early treatment by Compound Phyllanthus Urinaria L. (CPUL) on patients with preneoplastic hepatitis B virus (HBV)-associated HCC.

METHODSA total of 102 cirrhosis patients with regenerative or dysplastic nodules whose sera were tested positive for at least one of these six proteins (five up-regulated genes URG4, URG7, URG11, URG12 and URG19, and one down-regulated gene DRG2) were assigned randomly to two groups using continual random codes by SPSS software. Fifty-two patients were in the treatment group and 50 patients were in the control group. CPUL was used in the treatment group for 3 years, while the control group did not receive any treatment. The changes in HBV-DNA level, number of antibodies, and hepatocarcinogenesis occurred were observed. Patients who did not develop HCC were followed up for another 2 years.

RESULTSHBV-DNA levels decreased ⩾2log in 22.2% (10/45) of patients in the treatment group in contrast to only 5.0% (2/40) of patients in the control group (P=0.0228). The number of antibodies that were tested positive in the treatment group (1.08±1.01) was significantly lower compared with the control group (2.11±1.12) after 24 months of drug treatment (P<0.01). Both the positive rates of anti-URG11 (33/52) and anti-URG19 (31/52) were over 60% at baseline in the two groups, and were decreased to 48.1% (25/52) and 46.2% (24/52) respectively at 36 months of drug treatment, while the rates increased to 68.0% (34/50) and 66.0% (33/50) respectively (P=0.0417, P=0.0436) in the control group. The positive rate of anti-DRG2 was increased to 55.8% (29/52) at 36 months of drug treatment, while in the control group was decreased to 36.0% (18/50, P=0.0452). Among the 102 patients who developed HCC, 2 were in the treatment group and 9 were in the control group, meaning that a significant difference between the two groups (P=0.0212). In 11 patients who developed HCC, anti-URG11 and anti-URG19 were always positive, while anti-DRG2 was negative. Patients newly developing HCC were 6 (20.0%) in the control group, and only one (2.5%) in the treatment group (P=0.0441) during 2-year follow-up after the end of the treatment.

CONCLUSIONSAnti-URG11, anti-URG19 and anti-DRG2 could be used as early markers in the prediction of the therapeutic efficacy of CPUL in treating preneoplastic HCC. CPUL is useful in preventing or delaying the development of HBV-associated cirrhosis to HCC.

Antibodies, Viral ; blood ; Carcinoma, Hepatocellular ; therapy ; virology ; DNA, Viral ; analysis ; Hep G2 Cells ; Hepatitis B virus ; genetics ; immunology ; pathogenicity ; Humans ; Liver Neoplasms ; therapy ; virology ; Phyllanthus ; chemistry ; Plant Extracts ; therapeutic use ; Precancerous Conditions ; virology

Classical swine fever virus (CSFV) causes a highly contagious disease among swine that has an important economic impact worldwide. CSFV strain LOM is an attenuated virus of low virulent strain of Miyagi isolated from Japan in 1956. Eight DNA fragments representing the genome of the CSFV strain LOM were obtained by RT-PCR. These were used to determine the complete nucleotide sequence and construct a full-length cDNA clone which was called Flc-LOM. Sequence analysis of the recombinant clone (Flc-LOM) revealed the presence of eight mutations, resulting in two amino acid substitutions, when compared to the parental sequence. RNA transcripts of both LOM and Flc-LOM were directly infectious in PK-15 cells. The rescued Flc-LOM virus grew more slowly than the parental virus, LOM, in the cells. Intramuscular immunization with Flc-LOM was safe and highly immunogenic in pigs; no clinical signs or virus transmission to sentinel animals were observed after 35 days. CSFV-specific neutralizing antibodies were detected 14 days post-infection. After challenge with the virulent CSFV strain SW03, pigs immunized with Flc-LOM were shown to be fully protected. Thus, our newly established infectious clone of CSFV, Flc-LOM, could serve as a vaccine candidate.
Animals ; Antibodies, Viral/blood ; Base Sequence ; Cell Line ; Classical Swine Fever/immunology/*virology ; Classical swine fever virus/*genetics/immunology/pathogenicity ; Cloning, Molecular ; DNA, Complementary/genetics/immunology ; Immunization/methods/standards/veterinary ; Molecular Sequence Data ; Neutralization Tests/veterinary ; RNA, Viral/chemistry/genetics ; Recombinant Proteins/immunology ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Sequence Analysis, DNA ; Specific Pathogen-Free Organisms ; Swine ; Virulence

Avian metapneumovirus (aMPV) causes upper respiratory tract infections in chickens and turkeys. Although the swollen head syndrome (SHS) associated with aMPV in chickens has been reported in Korea since 1992, this is the study isolating aMPV from chickens in this country. We examined 780 oropharyngeal swab or nasal turbinate samples collected from 130 chicken flocks to investigate the prevalence of aMPV and to isolate aMPV from chickens from 2004-2008. Twelve aMPV subtype A and 13 subtype B strains were detected from clinical samples by the aMPV subtype A and B multiplex real-time reverse transcription polymerase chain reaction (RRT-PCR). Partial sequence analysis of the G glycoprotein gene confirmed that the detected aMPVs belonged to subtypes A and B. Two aMPVs subtype A out of the 25 detected aMPVs were isolated by Vero cell passage. In animal experiments with an aMPV isolate, viral RNA was detected in nasal discharge, although no clinical signs of SHS were observed in chickens. In contrast to chickens, turkeys showed severe nasal discharge and a relatively higher titer of viral excretion than chickens. Here, we reveal the co-circulation of aMPV subtypes A and B, and isolate aMPVs from chicken flocks in Korea.
Animals ; Antibodies, Viral/blood ; Base Sequence ; *Chickens ; Glycoproteins/chemistry/genetics ; Metapneumovirus/immunology/*isolation & purification ; Molecular Sequence Data ; Paramyxoviridae Infections/immunology/*veterinary/virology ; *Phylogeny ; Poultry Diseases/immunology/*virology ; RNA, Viral/chemistry/genetics ; Respiratory Tract Infections/immunology/*veterinary/virology ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Sequence Alignment ; Sequence Analysis, DNA ; Serotyping ; Specific Pathogen-Free Organisms ; Turkeys

OBJECTIVETo investigate the inhibitory effect on HBV replication of antisense locked nucleic acid (LNA) targeting to both S and C genes in HBV transgenic mice.

METHODSThirty HBV transgenic mice were randomly divided into five groups (n = 6): glucose control group were treated with 5% glucose solution, liposome control group were treated with liposome alone, S group were treated with LNA targeting to S gene, C group were treated with LNA targeting to C gene, and dual-target group were treated with LNA targeting to both S and C genes. Antisense LNA was injected into mice via the tail vein. Serum HBsAg was quantified by TRFIA. Serum HBV DNA was quantified by real-time PCR. The expression of HBV C-mRNA in the liver was detected by RT-PCR. The expression of HBsAg and HBcAg in the liver was detected by immunohistochemistry. Serum ALB, ALT, BUN and CR were measured using an automatic biochemical analyzer. The effects of antisense LNA on mouse organs were investigated by HE staining.

RESULTS5 days after LNA injection, serum HBsAg levels in the dual-target group were reduced by 72.8%, and serum HBV DNA levels were decreased by 52.9%. These values were significantly higher than those in the control groups (all P < 0.05). No significant differences were noted in serum ALB, ALT, BUN and CR between the experiment groups and the control groups (all P > 0.05). The expression levels of HBsAg and HBcAg in the liver of dual-target group were significantly lower than those in the control groups. No significant histopathological abnormality was found in liver and kidney tissues in all groups.

CONCLUSIONAntisense LNA targeting to both S and C genes can significantly inhibit HBV replication in transgenic mice.

Animals ; Antiviral Agents ; pharmacology ; DNA, Viral ; blood ; Female ; Hepatitis B Core Antigens ; analysis ; blood ; Hepatitis B Surface Antigens ; analysis ; blood ; Hepatitis B virus ; drug effects ; genetics ; physiology ; Immunohistochemistry ; Injections, Intravenous ; Liposomes ; Liver ; chemistry ; Male ; Mice ; Mice, Transgenic ; Oligonucleotides ; pharmacology ; Oligonucleotides, Antisense ; pharmacology ; Random Allocation ; Transcription, Genetic ; Virus Replication ; drug effects

The aim of this study was to examine the efficacy of in ovo prime-boost vaccination against infectious bursal disease virus (IBDV) using a DNA vaccine to prime in ovo followed by a killed-vaccine boost post hatching. In addition, the adjuvant effects of plasmid-encoded chicken interleukin-2 and chicken interferon-gamma were tested in conjunction with the vaccine. A plasmid DNA vaccine (pcDNA-VP243) encoding the VP2, VP4, and VP3 proteins of the very virulent IBDV (vvIBDV) SH/92 strain was injected into the amniotic sac alone or in combination with a plasmid encoding chicken IL-2 (ChIL-2) or chicken IFN-gamma (ChIFN-gamma) at embryonation day 18, followed by an intramuscular injection of a commercial killed IBD vaccine at 1 week of age. The chickens were orally challenged with the vvIBDV SH/92 strain at 3 weeks of age and observed for 10 days. In ovo DNA immunization followed by a killed-vaccine boost provided significantly better immunity than the other options. No mortality was observed in this group after a challenge with the vvIBDV. The prime-boost strategy was moderately effective against bursal damage, which was measured by the bursa weight/body weight ratio, the presence of IBDV RNA, and the bursal lesion score. In ovo DNA vaccination with no boost did not provide sufficient immunity, and the addition of ChIL-2 or ChIFN-gamma did not enhance protective immunity. In the ConA-induced lymphocyte proliferation assay of peripheral blood lymphocyte collected 10 days post-challenge, there was greater proliferation responses in the DNA vaccine plus boost and DNA vaccine with ChIL-2 plus boost groups compared to the other groups. These findings suggest that priming with DNA vaccine and boosting with killed vaccine is an effective strategy for protecting chickens against vvIBDV.
Adjuvants, Immunologic/pharmacology ; Animals ; Antibodies, Viral/blood ; Birnaviridae Infections/immunology/prevention & control/*veterinary/virology ; Body Weight/immunology ; Bursa of Fabricius/immunology ; Chick Embryo ; *Chickens ; Histocytochemistry/veterinary ; Immunization/*veterinary ; Infectious bursal disease virus/genetics/*immunology ; Interferon-gamma/pharmacology ; Interleukin-2/pharmacology ; Organ Size/immunology ; Poultry Diseases/immunology/*prevention & control/virology ; RNA, Viral/chemistry/genetics ; Random Allocation ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Specific Pathogen-Free Organisms ; Vaccines, DNA/*administration & dosage/immunology ; Vaccines, Inactivated/administration & dosage/immunology ; Viral Vaccines/*administration & dosage/immunology

OBJECTIVESTo establish a Chinese national standard for a nucleic acid test (NAT) for HBV DNA.

METHODSThe candidate sample of HBV DNA positive plasma was diluted with HBV-negative human plasma. The sample was lyophilised with a concentration of approximately 300,000 copies/ml. The measurement methods used included Roche Amplicor assay (version 2.0) and real-time PCR. The lyophilised preparation was calibrated by the international standard (NIBSC code: 97/746) from NIBSC.

RESULTSThe quantity of this lyophilised preparation was (1.29+/-0.24) x 10(5)IU/ml in comparison with the international standard for HBV DNA 97/746. The stability test indicated that the sample was stable at room temperature (20 to 25 degrees C) for 2 weeks and at 37 degrees C for at least 1 week. Long-term stability was observed at 2 to 8 degrees C for 6 months and at -20 degrees C for more than 2 years with no significant changes. The vial-to-vial imprecision rate was 3.53%.

CONCLUSIONBased on the results of this study, our lyophilized sample can be used as a standard in China for the nucleic acid test (NAT) for HBV DNA.

DNA, Viral ; blood ; Hepatitis B virus ; genetics ; Humans ; Nucleic Acid Amplification Techniques ; standards ; Plasma ; chemistry

OBJECTIVETo study curative effect of chronical hepatitis B with treatment of integrative traditional Chinese and western medicine.

METHOD115 cases of HBeAg and/or HBVDNA positive chronical hepatitis B were randomly divided into two groups in control. The first group treated by traditional Chinese medicine (TCM)-Fufang Huangqi granule and the second treated by intergrative traditional Chinese and western medicine (ICWM)-Fufang Huangqi granule and lamivudine for at least 24 weeks.

RESULTThe positive rate of HBVDNA at 12, 24 weeks, and the positive rate of HBeAg at 24 weeks in TCM are markedly lower than those of before treatment (P < 0.01). The positive rate of HBeAg and the positive rate of HBVDNA in ICWM are markedly lower than those of before treatment both at 12, 24 weeks (P < 0.01). The average values of HBVDNA are markly lower than before treatment in two groups at both 12,24 weeks (P < 0.01). At 12 weeks, the negative-turning rate of HBVDNA in the ICWM group is 79.17%, which shows significant difference in comparision with 40.00% in the TCM group (P < 0.01). The negative-turning rate of HBeAg in the ICWM group is 26.92%, which shows no significant difference in comparision with 32. 08% in the TCM group. At 24 weeks, the negative-turning rate of HBVDNA in the ICWM group is 85.71%, which shows significant difference in comparision with 50.00% in the TCM group (P < 0.01). The negative-turning rate of HBeAg in the ICWM group is 36.36%, which shows no significant difference in comparision with 28.57% in the TCM group. At 12 weeks,the total effective rate of the ICWM group is 96. 43%, which shows significant difference in comparision with 71.26% in the TCM group (P<0.01). At 24 weeks, the total effective rate of the ICWM group is 88. 00%, which shows significant difference in comparision with 67.61 % in the TCM group (P < 0.01). The average values of ALT and AST are markly improved than those of before treatment in two groups (P < 0.01). The average values of ALB is markly higher than before in TCM groups after 24 weeks treatment (P < 0.01).

CONCLUSIONFufang Huangqi granule integrated with lamivudine possesses a better effect for counteracting the hepatitis B virus and improving the liver functioin than only itself.

Adolescent ; Adult ; Aged ; Albumins ; metabolism ; Anti-HIV Agents ; therapeutic use ; Astragalus membranaceus ; chemistry ; DNA, Viral ; blood ; Drug Combinations ; Drug Synergism ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Plants, Medicinal ; chemistry