ObjectiveTo systematically review the efficacy of different nucleosides (acids) in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of different nucleosides (acids) to prevent HBV reactivation after chemotherapy in cancer patients from inception to June 7th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Network meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 43 RCTs involving 3 269 patients were included. There were 7 interventions, namely entecavir (ETV), lamivudine (LAM), adefovir dipivoxil (ADV), telbivudine (LdT), tenofovir dipivoxil (TDF), lamivudine combined with entecavir (LAM+ETV), and lamivudine combined with adefovir dipivoxil (LAM+ADV). The results of network meta-analysis showed that the efficacy of reducing the reactivation rate of ETV, LAM, ADV, LdT, TDF, LAM+ETV, LAM+ADV were superior than the control group. The ETV, LAM and ADV were not as effective as LAM+ETV. The leading drug combinations were LAM+ETV (94.8%), LdT (81.5%) and LA+ADV (58.0%). ConclusionsCurrent evidence shows that LAM+ETV, LdT, and LA+ADV are more effective in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
Hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) has the characteristics of rapid progress and high mortality. Artificial liver support system (ALSS) is far superior to standard drug therapy in the treatment of such patients, and is widely used in emergency. ALSS is the use of external mechanical or biological devices to replace a part of the damaged liver function, divided into bioartificial, non-bioartificial liver and a combination of the two. At present, there is no unified sensitive prognostic index and recognized prognostic model for HBV-ACLF in artificial liver treatment. This paper reviews the research progress of prognosis evaluation of ALSS in the treatment of HBV-ACLF, in order to provide reference for clinicians and researchers
Objective To assess the effectiveness and safety of hepatitis B immunoglobulin (HBIG) in interrupting the intrauterine transmission of HBV.Methods The Cochrane Library (Issue 3, 2007), MEDLINE (1996 to April 2007), CBM (1978 to April 2007), and EMBASE (1980 to April 2007) were searched. The quality of included studies was evaluated and meta-analysis was performed. Results Four studies involving 359 participants with HBVDNA (+) were included. All the included studies were judged to be inadequate in regard to the reporting of randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that HBIG significantly decreased the intrauterine transmission rate of HBV compared to the control group [OR 0.17, 95%CI (0.09 to 0.31), Plt;0.000 01]. No HBIG-related severe adverse reactions were reported. Conclusions HBIG is effective and safe for the interruption of intrauterine transmission of HBV. However, because of the high risk of selection and detection bias in the included studies, this evidence is not b enough. Large-scale randomised trials on the use of HIBG for the interruption of intrauterine transmission of HBV are needed
ObjectiveTo evaluate the effectiveness of mass vaccination campaign of hepatitis A vaccine (Hep A) and Measles-Mumps-Rubella live attenuated vaccine (MMR) vaccine in children in stricken regions of 4.20 Lushan earthquake in Sichuan province. MethodsAs the requirements of Sichuan Provincial Health Bureau, the mass campaign was implemented in Lushan county, Baoxing county and the victim settlement localities of other 6 counties during May 6th to 12th, 2013. Hep A and MMR were vaccinated, which targeted children aged from 18 months to 14 years and children aged from 8 months to 14 years, respectively. The vaccination rates were evaluated through reports and on-site rapid review of earthquake regions. ResultsAs of May 16th, 2013, 38 988 doses of Hepatitis A vaccine and 38 696 doses of MMR vaccine were vaccinated in 8 counties of Ya'an. Based on reports, the vaccination rates of Hep A and MMR vaccine of Ya'an were 99.01% and 98.87%, respectively. Based on reviews, vaccination rates of Hep A and MMR vaccine of Lushan and Baoxing were 97.40% and 97.06%, respectively. ConclusionMass vaccination campaign of Hep A and MMR in children in stricken regions of 4.20 Lushan earthquake in Sichuan province yields expected results. The mass campaign is wellorganized and implemented effectively, and the coverage matches the requirements. Timely decision, assistance from associated prefectures and the establishment of Childhood Immunization Information System play an important role in the campaign.
【Abstract】Objective To investigate the prevention and treatment for recurrence of hepatitis B after liver transplantation on HBV-related diseases. Methods Making a literature summarization based on published papers review.Results Acute and chronic HBV-related diseases are the main indications of liver transplantation.Recurrence rate of hepatitis B is from 80% to 100% in the untreated patients after liver transplantation,and it affects the survivals of patients seriously.It has become a focus to prevent and treat the recurrence of hepatitis B.After a series of explotation and application,there have been a lot of drugs of preventing and treating HBV reinfection, including hepatitis B immunoglobulin,interferon and nucleotide analog antivirus drugs(lamivudine, famcyclovir, adefovir),etc.The therapeutic characteristics of them are different. Their utilizations of dividing or alliance are developing rapidly.Conclusion Liver transplatation is an effective therapy for HBV-related disease. Anti-HBV treatments perioperation play an important role in the improvement of succeed of liver transplantation.
ObjectiveTo explore the predictive value of serum prothrombin induced by vitamin K absence-Ⅱ (PIVKA-Ⅱ) detection for the biological characteristics of hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC).MethodsThis retrospective study included 394 patients with HBV-related HCC who were newly diagnosed and treated with surgical resection in West China Hospital of Sichuan University between June 2017 and December 2018. Their clinical information such as tumor size, tumor number, tumor cell differentiation, presence of microvascular invasion (MVI), distant metastasis, and portal vein tumor thrombus was collected from the medical record. The laboratory test results of patients during diagnosis and before surgery were collected, including alpha-fetoprotein (AFP), PIVKA-Ⅱ, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GGT), etc., and the relationships between PIVKA-Ⅱ levels and tumor biological characteristics were analyzed. Non-normal continuous variables were presented as medium (lower quartile, upper quartile).ResultsCompared with the patients with low HCC serum PIVKA-Ⅱ levels (≤40 mAU/mL), patients with high serum PIVKA-Ⅱ levels (>40 mAU/mL) had larger tumor diameters [5.00 (3.00, 9.00) vs. 2.50 (1.63, 4.95) cm, P<0.001], more severe Barcelona Clinic Liver Cancer (BCLC) stage (P<0.001), and higher AFP [186.05 (6.86, 1 210.00) vs. 17.83 (4.33, 231.95) ng/mL, P<0.001], ALT [38.00 (26.00, 66.25) vs. 32.00 (22.00, 51.00) U/L, P=0.018], AST [42.00 (30.00, 76.00) vs. 34.00 (25.50, 48.25) U/L, P<0.001], and γ-GGT [71.00 (39.00, 165.50) vs. 55.50 (25.00, 93.00) U/L, P=0.005], and were more likely to form portal vein tumor thrombi (16.61% vs. 3.75%, P=0.003) and MVI (43.67% vs. 11.11%, P<0.001). In BCLC stage 0 HCC patients, the positive rate of PIVKA-Ⅱ was only 51.35%. Multivariate logistic regression analysis showed that PIVKA-Ⅱ>40 mAU/mL was an independent predictor of MVI [odds ratio=6.588, 95% confidence interval (CI) (1.645, 26.383), P=0.008]. The area under receiver operating characteristic curve of PIVKA-Ⅱ level predicting MVI was 0.761 [95%CI (0.693, 0.830)], with a sensitivity of 66.22% and a specificity of 79.06%.ConclusionIn HBV-related HCC patients, high PIVKA-Ⅱ is associated with the poor biological characteristics of tumor, and is an independent risk factor for tumor MVI.
ObjectiveTo detect the expression of indoleamine2, 3-dioxygenase (IDO) and HBV preS mRNA in HepG2 cells and its inhibitory effect on the proliferation of human peripheral blood lymphocyte. MethodsThe AdIDOEGFPpreS was transfected to human hepatocarcinoma cell line HepG2 and the specific fragment of IDO mRNA and HBV preS mRNA in these HepG2 cells were detected by RT-PCR. Then the transfected HepG2 cells were cocultured with human peripheral blood lymphocyte and the inhibitory effect of IDO on the proliferation of human peripheral blood lymphocyte was observed. ResultsThe IDO and HBV preS mRNA were successfully transferred to HepG2 cells, so the specific fragment of IDO and HBV preS mRNA could be found in the transfected HepG2 cells but not in the control group HepG2 cells by RT-PCR. Furthermore, the relative expression intensity of IDO and HBV preS were 1.27 and 1.18, respectively. When co-cultured with human peripheral blood lymphocyte, the counts per minute in the transfected HepG2 cells 〔(7 471±1 375) beats/min〕 was significantly less than that in the control group 〔(13 821±1 997) beats/min〕, Plt;0.001. ConclusionThe target gene IDO and HBV preS can be transferred and expressed in HepG2 cells successfully, which can obviously suppress the proliferation of human peripheral blood lymphocyte.
Objective To analyze the clinical characteristics of individuals with high hepatitis B virus (HBV) pregenomic RNA (pgRNA), and further explore the value of pgRNA in the management of patients with chronic hepatitis B. Methods From December 1st, 2020 to April 1st, 2022, chronic hepatitis B patients who had been treated with nucleotide analogues for a long time and followed up in the Hepatitis Clinic of the Center of Infectious Diseases, West China Hospital, Sichuan University were included, and the clinical characteristics of chronic hepatitis B patients with high pgRNA were analyzed and summarized. Results A total of 107 patients were included. Male patients accounted for 66.4%, with an average age of 44.02 years. There were no statistically significant differences in gender, age, aspartate transaminase, alanine transaminase, γ-glutamyl transferase, HBV surface antigen, proportion of patients with HBV e antigen ≥0.1 U/mL, HBV DNA, and alpha fetoprotein between the high and low pgRNA groups (P>0.05). The proportion of patients with HBV surface antigen<100 U/mL in the high pgRNA group was lower than that in the low pgRNA group (4.4% vs. 22.6%, P<0.05). Conclusion The proportion of chronic hepatitis B patients with high pgRNA whose HBV surface antigen≥100 U/mL is higher.
ObjectiveTo investigate the influence of strengthening intervention on antiviral treatment compliance for cirrhosis patients following chronic hepatitis B. MethodsOne hundred patients with cirrhosis following chronic hepatitis B undergoing antiviral treatment between January 2007 and January 2009 were randomly divided into intervention group and control group with 50 patients in each group.Patients in the control group received routine care.For patients in the intervention group,besides routine care,strengthening education on the disease,medication guide,and weekly telephone follow-up after discharge were also added.On the time points of 6,12,18,24,30,36 months after patients were discharged,we followed them up with self-designed questionnaire,and compared the two groups of patients on the rates of fully complying with doctors,not fully complying with doctors and completely not complying with doctors.And the reasons were also analyzed. ResultsEighteen months after being discharged,the two groups had no significant difference in the rate of complying with doctors (P>0.05),while the difference was significant 24,30,36 months after leaving the hospital (P<0.05).The reasons were not following the doctors were mainly high cost and unsatisfying treatment effect.In the control group,the reasons also included lack of knowledge about the disease and lack of guidance and supervision. ConclusionThrough strengthening nursing intervention,patients'treatment compliance can be improved significantly.
ObjectiveTo systematically evaluate the association between human leukocyte antigen DQ (HLA-DQ) gene rs2856718A>G, rs9275572A>G polymorphisms and the risk of chronic hepatitis B. MethodsPubMed, EMbase, CBM, WanFang Data, CNKI and VIP databases were systematically searched from inception to April 2015 to collect case-control studies about HLA-DQ gene polymorphisms and the risk of chronic hepatitis B. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software, and Stata 12.0 software was used for sensitivity and publication bias analysis. ResultsA total of 6 papers involving 8 case-control studies were included, which involved 3 690 cases and 6 267 controls. The results of meta-analysis showed that:the rs2856718A>G polymorphism was associated with the decreased risk of chronic hepatitis B (AG+GG vs. AA:OR=0.63, 95%CI 0.51 to 0.78, P=0.000; GG vs. AG+AA:OR=0.69, 95%CI 0.61 to 0.79, P=0.000; GG vs. AA:OR=0.56, 95%CI 0.48 to 0.64, P=0.000; GA vs. AA:OR=0.64, 95%CI 0.47 to 0.88, P=0.006; G vs. A:OR=0.74, 95%CI 0.68 to 0.79, P=0.000). The rs9275572A>G polymorphism was not associated with the risk of chronic hepatitis B (AG+GG vs. AA:OR=1.11, 95%CI 0.55 to 2.23, P=0.770; GG vs. AG+AA:OR=1.10, 95%CI 0.84 to 1.45, P=0.500; GG vs. AA:OR=1.14, 95%CI 0.54 to 2.41, P=0.730; AG vs. AA:OR=1.06, 95%CI 0.56 to 2.02, P=0.860; G vs. A:OR=1.11, 95%CI 0.83 to 1.48, P=0.490). ConclusionHLA-DQ gene rs2856718 A>G polymorphism is significantly associated with decreased risk of chronic hepatitis B, but the rs9271319 A>G polymorphism is not associated with the risk of chronic hepatitis B.