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标题: HBV Journal Review March 1, 2012, Vol 9, no 4 by Christine M. Kukka [打印本页]

作者: StephenW 时间: 2012-4-3 12:06 标题: HBV Journal Review March 1, 2012, Vol 9, no 4 by Christine M. Kukka

本帖最后由 StephenW 于 2012-4-3 20:14 编辑

Pegylated Interferon and Adefovir Combination More Effective Than Interferon Alone
Researchers are trying to determine if a combination of pegylated interferon (Pegasys, which boosts the immune system) and antivirals (which hinder the virus' ability to replicate) is more effective than interferon alone.

In this study, published in the March 2012 issue of the journal Hepatogastroenterology, researchers treated 160 patients with either pegylated interferon alone (which requires a weekly injection) or with a combination of the interferon plus the antiviral adefovir (Hepsera).

At week 24, the percentage of patients who achieved normal alanine aminotransferase (ALT) levels (which indicate no liver damage) and undetectable viral load (HBV DNA) were higher in the combination group (57.50% and 43.75% respectively) than in the interferon-only group (40% and 27.5%).

After 96 weeks of treatment, 46—25% of the patients treated with both interferon and adefovir—cleared the hepatitis B “e” antigen (HBeAg) and developed "e" antibodies (called seroconversion) compared to 30% in the interferon-only group.

"Furthermore, there was no statistically significant difference in relapse rates and adverse events between the two groups," researchers noted.

Researchers concluded that the combination therapy, "... can accelerate undetectable HBV DNA and elevate HBeAg clearance/seroconversion rates to a greater degree," than with just interferon.

Many Younger Patients with Liver Cancer Don't Experience Cirrhosis, So Diagnoses Are Delayed
Current practice guidelines do not call for aggressive liver cancer screening in young adults (age 40 or younger) who do not have cirrhosis (severe liver scarring), which is considered a precursor to liver cancer.

But a multinational team of researchers decided to study hepatitis B patients were who recently diagnosed with liver cancer to make sure the current screening guidelines were effective in finding liver cancer early through alpha fetoprotein (AFP) tests and ultrasounds.

According to their report published in the April Journal of Digestive Diseases, doctors assessed 93 patients admitted to Bellevue Hospital Center with liver cancer.

Eighteen of the cancer patients were younger than 40, and only 12 (66.7%) of them had cirrhosis.

"Current guidelines for liver cancer screening in patients with HBV may lead to a delay in diagnosis in non-cirrhotic patients under 40 years," researchers noted.

"Consideration should be given to modifying current recommendations to advocate entering HBV patients into a cancer-screening program at young age."

Doctors May Miss HBV in HIV-Infected Patients
Doctors, writing in the International Journal of STD and AIDS, reported on a case of a missed hepatitis B infection in an HIV-infected man who had tested negative for the hepatitis B core antibody (anti-HBc). This test is commonly used to identify past and current HBV infections.

After he tested negative for the core antibody, he was immunized with the three doses of hepatitis B vaccine. However, doctors noticed that his ALT levels remained above normal. During this period, he received antiviral treatment for his HIV infection. These antivirals are not always effective against hepatitis B, and one—lamivudine—can quickly cause drug resistance.

Another round of hepatitis B testing finally revealed he was positive for the hepatitis B surface antigen (HBsAg) and HBV DNA. He was switched to tenofovir (Viread), an antiviral that is effective against both HIV and HBV.

Researchers cautioned doctors to perform more thorough screening for hepatitis B among those infected with HIV, beyond the core antibody test, in their report in the International Journal of STD and AIDS.

In an unrelated study, researchers presenting at the 19th Conference on Retroviruses and Opportunistic Infections reported success in treating HIV-HBV coinfected patients with tenofovir. About 17% of HBeAg-positive patients cleared HBeAg after one year and 47% cleared it after six years of treatment. About 23% lost HBeAg and developed "e" antibodies after six years of tenofovir.

Five (8%) of the HBeAg-positive patients lost HBsAg during treatment, as did three HBeAg-negative patients.

Researchers noted that 71% of HBeAg-positive coinfected patients with HBsAg levels below 100 IU/mL cleared HBsAg after six months of treatment.

Low Levels of HBsAg and HBV DNA Could Predict Viral Clearance
Researchers closely followed people who were HBeAg-negative and who eventually lost HBsAg to see what characteristics could predict loss of HBsAg. Knowing these attributes may be valuable to doctors who are trying to decide when to stop treatment or when treatment is needed.

They compared 203 HBeAg-negative patients who spontaneously cleared HBsAg without treatment with 203 other HBeAg-negative patients of similar age and gender. They screened the patients' HBsAg and HBV DNA levels and found that average HBsAg levels were:

23.5 IU/mL in patients three years before HBsAg clearance
3.51 IU/mL two years before clearance
0.524 IU/mL one year before clearance
and 0.146 IU/mL six months before clearance.

Those who cleared HBsAg consistently had lower HBsAg and HBV DNA levels compared to those in the control group who did not clear HBsAg. While HBsAg levels did decrease slightly over time in the control group, HBV DNA levels remained constant and did not decline.

Researchers reported in the March issue of Hepatology that patients who had HBsAg levels less than 200 IU/mL, and who had regular reductions in HBsAg of 50% annually may clear HBsAg within three years.

Hepatitis B Patients May Need Selenium Supplements
Pakistani researchers discovered that people experiencing hepatitis B-related liver damage may have deficiencies in selenium—an essential trace mineral that strengthens the immune system. Selenium contributes to the creation of antioxidants that help protect people from cancer and heart disease.

They measured selenium levels in 150 patients infected with HBV and HCV and compared those levels with 26 healthy people. They found selenium levels higher in healthy individuals than in those with viral hepatitis. The more liver disease patients had, the lower were their selenium levels.

"Based on findings of this study, it is proposed that selenium should be supplemented in such patients in order to optimize nutritional support and to get better treatment response," they wrote in the March issue of the Saudi Journal of Gastroenterology.

HBV Infection in Women Does Not Affect Gender of Offspring
Does the presence of hepatitis B infection increase the chance that a woman will give birth to a son? No say Taiwanese researchers, writing in the March issue of American Journal of Human Biology.

They studied the hepatitis B status of 90% of 3 million women who gave birth in Taiwan between 1988 and 1999.

Five percent of the women who gave birth were HBeAg-positive, and they were "slightly" more likely to have a son (on average they gave birth to 108 sons compared to 106 daughters). Age, birth order, mother's age, birth year and area of residence had no impact on this ratio, nor apparently did hepatitis B status.

Lamivudine May Be Effective for Some, If Carefully Monitored
Lamivudine is the cheapest and most widely available antiviral available worldwide, but current guidelines do not recommend this drug due to its high rate of drug resistance. But are there some patients for whom lamivudine is an inexpensive and effective option?

Researchers followed 369 patients over 10 years and zeroed in on 47 patients (36 male, average age 44) who were treated with lamivudine and carefully monitored over several years.

Lamivudine worked in 45 (96%) patients, with 88% achieving undetectable viral load after four years, along with a decrease in liver damage. Seven of 13 HBeAg-positive patients seroconverted and developed “e” antibodies. Treatment was ineffective in only 11% of the patients.

Based on these researchers concluded that lamivudine could still be used in patients, but only if the patients were monitored every six to 12 months to identify treatment failure, according to their report in the March issue of the Canadian Journal of Gastroenterology.

Testing All Patients with Elevated ALTs May Identify Hepatitis
Health care providers often do not screen at-risk patients for hepatitis B and C, which is why 70% of people infected with HCV and about 60% of people infected with HBV do not know they are infected and remained untreated.

One indication of viral hepatitis infection is elevated ALT levels. These liver enzymes increase above normal when liver cells are damaged and die.

Dutch researchers decided to see if would be worthwhile to screen primary care patients with elevations in ALT for viral hepatitis.

They screened 750 blood samples from patients whose ALT levels were mildly elevated (30-50 IU/l), moderately elevated (50-70 IU/l, and critically elevated (70-100 IU/l). They then tested the samples for HCV and HBV.

They found that people with ALT levels of 50-100 IU/l, had a hepatitis C infection rate that was ten-fold higher than in the general population. An above-normal rate of HBV was not identified in patients with elevated ALT levels.

As a result, according to researchers writing in the British Journal of General Practice, “…follow-up for HCV is indicated in these patients, even when other explanations for ALT elevation are present.”

Only 34% of Elderly Can Be Successfully Immunized Against Hepatitis B
Recently, epidemiologists have identified outbreaks of hepatitis B in long-term care facilities due to improper re-use of diabetes testing equipment.

To determine how effective immunization would be, CDC researchers immunized seniors (average age 79.5, 56% female, 51% African-American) against hepatitis B, and then screened them to see if they had enough antibodies to fight off infection.

According to their report published in the March issue of the journal Vaccine, only 29 (34%) of 86 residents who received all three vaccine doses responded successfully and developed enough hepatitis B surface antibodies to prevent infection.

"There were no significant differences in vaccine response by age, gender, race, diabetes status, body mass index, or current smoking status," they wrote. "Our findings indicate that a low proportion of skilled nursing facility residents achieved a seroprotective response after hepatitis B vaccination."

Surface Antigen Declines with Onset of Cirrhosis and Liver Cancer
Ironically, the amount of HBsAg circulating in the bloodstream of hepatitis B patients decline as they develop cirrhosis and liver cancer, according to a report published in the Chinese medical journal Zhonghua Gan Zang Bing Za Zhi.

HBsAg and HBV DNA levels were monitored in 47 chronic hepatitis B patients, 72 patients with cirrhosis, and 54 liver cancer patients.

The average HBsAg levels:

Decreased from 2,361.10 IU/ml in chronic hepatitis B patients to 1,001.64 IU/ml in cirrhotic patients and down to 594.35 IU/ml in liver cancer patients.
Among HBeAg-positive patients, HBsAg decreased from 3259.83 IU/ml in the chronic patients to 1,077.30 IU/ml in the cirrhotic group and then to 789.72 IU/ml in the liver cancer group.
Among HBeAg-negative patients, HBsAg declined from 1,669.00 IU/ml in the chronic group to 1,001.64 IU/ml in the cirrhotic group and 582.05 IU/ml in cancer group.

Elevated ALT Levels Do Not Accurately Predict Liver Damage
Between 1994 and 2008, Hong Kong researchers performed liver biopsies on 319 untreated hepatitis B patients to study the relationship between ALT levels and liver damage.

In the study, 211 patients were HBeAg-positive and 108 were HBeAg-negative, with an average age of 31 and 46 years respectively.

Nine of 40 (22.5%) HBeAg-positive patients who had normal ALT (30 U/L for men, 19 U/L for women) had significant liver damage.

Age, aspartate aminotransferase (another enzyme that indicates liver health) and platelet count were all good indicators of who had significant fibrosis among HBeAg-positive patients with elevated ALT levels.

Among HBeAg-negative patients, viral load and platelet count were better predictors of liver damage.

What was significant was that an elevated ALT level did not always accurately predict the presence of liver damage or significant fibrosis among either HBeAg-positive or -negative patients.

In fact, there was no significant difference in fibrosis among patients with moderately elevated ALT (one to two-times the upper limits of normal) and those with more than twice the upper level of normal for both HBeAg-positive and -negative infections, according to Hong Kong researchers' report published in the journal PLoS One.

They concluded that, "an elevated ALT does not accurately predict significant liver injury." Doctors should consider more than just ALT when making decisions about initiating treatment, they noted.

One-Third of Hepatitis B Patients Forget to Take Their Daily Antivirals
A recent article in the World Journal of Hepatology suggests that many hepatitis B patients often forget to take their daily antiviral pills. It is important to take antiviral medications regularly, because poor adherence can lead to development of antiviral resistance.

Australian researchers asked 80 patients about their antiviral adherence in a survey and discovered that only 66% took the pills as prescribed while 25 (33.8%) reported they often forgot their medications. The most common reason cited by patients was forgetfulness, running out of medications, being too busy, and recent changes in daily routines.

"Adherence rates were much less than that expected by the physician and has potential adverse affect on long term outcome," doctors noted.

New MicroRNA Test Very Effective in Identifying Liver Cancer
Today, an alpha fetoprotein (AFP) tests performed on a blood sample is the most common test used to identify liver cancer--but it fails to identify cancer in nearly half of all patients.

A new test using microRNAs (miRNAs)—small RNA molecules that can signal the presence of tumors--appears to be more accurate and could eventually replace AFP tests, according to a report in the online journal BMJ Open.

Researchers measured and compared miRNAs in 57 liver cancer patients, 29 hepatitis B patients, and 30 healthy people in China.

The miRNAs were an effective biomarker for liver cancer, and markedly declined after patients had liver tumors removed surgically, confirming that the tumors produce the miRNAs.

The miRNA test found cancer in 96.7% of cases, while AFP tests are only 50% effective. The new test found very early-stage cancers that were completely missed by AFP tests.

作者: StephenW 时间: 2012-4-3 12:08

聚乙二醇干扰素和阿德福韦组合仅比干扰素更有效
研究人员正试图确定是否结合聚乙二醇干扰素（派罗欣，增强免疫系统）和抗病毒药物（从而阻碍病毒的复制能力），仅比干扰素更有效。

在这项研究中，发表在2012年3月杂志胃肠肝胆的问题，研究人员无论是聚乙二醇干扰素（这需要每周注射）单独或与干扰素的组合，加上抗病毒药物阿德福韦（阿德福韦酯）治疗160例。

在第24周，取得了正常的谷丙转氨酶（ALT）水平（这表明没有肝功能损害），检测不到病毒载量（HBV - DNA）的患者比例在联合治疗组（分别为57.50％和43.75％）高于干扰素只组（40％和27.5％）。

经过96周的治疗，有46-25％的患者同时干扰素和阿德福韦治疗清除乙肝“E”抗原（HBeAg）和开发的“e”抗体（称为血清转换）相比，干扰素仅30％组。

“此外，有没有统计学显着性差异，两组之间的复发率和不良事件的研究人员指出，”。

研究人员得出结论，综合疗法，“......可以加速不到的HBV DNA和HBeAg的清除/血清转换率更大程度提升，”比只用干扰素。

许多年轻的肝癌患者不要遇到肝硬化，因此延迟诊断
现行做法准则不要求积极青壮年肝癌筛检（40岁或以下）谁没有肝硬化（严重的肝脏结疤），这被认为是肝癌的前兆。

但跨国团队的研究人员研究决定，乙肝患者是谁最近确诊为肝癌，以确保当前的筛选准则是通过甲胎蛋白（AFP）测试和超声波检查早期发现肝癌的有效。

根据他们在四月消化系统疾病杂志公布的报告，医生评估承认，贝尔维尤与肝癌的中心医院93例。

的癌症患者中有18人年龄低于40岁，其中12只（66.7％）有肝硬化。

“目前的指导方针与乙肝患者肝癌筛查可能会导致在40岁以下的延迟在非肝硬化患者的诊断，研究人员指出。”

“应考虑修改目前的建议，主张进入一个年纪轻轻的癌症筛查方案的乙肝患者。”

医生可能会错过在艾滋病毒感染者HBV
医生，性病和艾滋病的国际杂志报道上错过肝炎测试为阴性乙肝核心抗体（抗-HBc），在感染艾滋病毒的男子B组病毒感染的情况下，以书面形式。这项测试是常用来确定过去和目前的乙肝病毒感染。

后，他为核心抗体测试负，他与三个剂量乙肝疫苗免疫接种。然而，医生发现他的ALT水平仍然高于正常。在此期间，他接受了他的艾滋病毒感染的抗病毒药物治疗。并不总是有效的，这些抗病毒药物对乙肝，和一个拉米夫定可迅速导致耐药。

另一轮B型肝炎测试，终于发现他是乙肝表面抗原（HBsAg）和HBV DNA阳性。他被交换到泰诺福韦（VIREAD），是对HIV和HBV有效的抗病毒药物。

研究人员提醒医生进行更彻底的B型肝炎筛检艾滋病毒感染者中，超出了核心抗体检测，性病和艾滋病的国际杂志的报告。

在一个不相关的研究中，研究人员在19逆转录病毒和机会性感染大会提出报告泰诺福韦治疗艾滋病毒HBV合并感染患者的成功。清除一年后约17％的HBeAg阳性患者HBeAg和6年的治疗后清除47％。泰诺福韦六年后失去了约23％，HBeAg和开发的“E”的抗体。

五（8％）HBeAg阳性患者在治疗过程中失去了乙肝表面抗原一样，三个HBeAg阴性患者。

研究人员指出，清除后6个月的治疗乙肝表面抗原HBsAg水平低于100 IU / mL的HBeAg阳性合并感染患者的71％。

HBsAg和HBV DNA水平低，可以预测病毒清除
研究人员密切注视HBeAg阴性的人，并最终失去了乙肝表面抗原，看看有什么特点，可以预测HBsAg消失。了解这些属性可能是有价值的医生正试图决定何时停止治疗或治疗时需要。

他们比较了203例HBeAg阴性患者自发清除不相似的年龄和性别与其他203 HBeAg阴性患者的治疗乙肝表面抗原。他们筛选患者的HBsAg和HBV DNA水平和发现HBsAg的平均水平分别为：

23.5 IU /毫升的患者HBsAg清除前三年
3.51 IU / mL的前两年，通关
0.524 IU / mL的一年批准前
和0.146 IU / mL的6个月前清拆。

那些清除HBsAg的一致相比，那些在对照组中没有明确的HBsAg HBsAg和HBV DNA水平较低。虽然HBsAg水平确实比对照组略有减少，HBV DNA水平保持不变，并没有下降。

研究人员报告在三月发行的肝病患者曾HBsAg水平低于200国际单位/毫升，并定期在每年50％的乙肝表面抗原减少，可能在三年内清除乙肝表面抗原。

B型肝炎患者可能需要硒补充剂
巴基斯坦的研究人员发现，遇到B型肝炎相关的肝功能损害的人，可能硒必不可少的微量元素，能增强免疫系统有缺陷。硒有助于创造的抗氧化剂，帮助防止癌症和心脏疾病的人。

他们测量了150例患者中，乙型肝炎病毒和丙型肝炎病毒感染，并与26名健康人相比，这些级别中的硒含量。他们发现，硒含量高于病毒性肝炎的健康人。更多的肝病患者，低硒水平。

“基于这项研究的结果，因此建议，应在此类患者补充硒以优化营养支持，并得到更好的治疗反应，他们写道：”在沙特胃肠病学杂志三月号。

妇女乙肝病毒感染不会影响后代的性别
是否存在乙肝病毒感染增加机会，一个女人会生出一个儿子呢？没有说，台湾的研究者，写在“美国人类生物学杂志三月号。

他们研究的90％，300万妇女，谁给台湾1988年和1999年之间出生的B型肝炎状态。

5％的妇女生下的HBeAg阳性，他们是“略”更可能有一个儿子（平均而言，他们生下了108相比，106的女儿的儿子）。年龄，出生顺序，母亲的年龄，出生年份和居住面积有没有这个比例的影响，也显然没有B型肝炎状态。

拉米夫定对某些人可能是有效的，如果仔细监测
拉米夫定是最廉价和最广泛使用的抗病毒药物的全球发售，但目前的指导方针不建议这种药物，由于其高耐药率。但有一些病人，对他们来说，拉米夫定是一种廉价和有效的选择吗？

研究人员随后10年以上369例，对47例患者（男性36例，平均年龄44）人与拉米夫定治疗仔细监测，在过去几年归零。

拉米夫定治疗45例（96％），88％，实现四年后不到病毒载量，减少肝损伤。七个13 HBeAg阳性患者的血清阳转和开发的“E”的抗体。只有11％的患者的治疗是无效的。

基于这些研究人员得出结论，拉米夫定患者仍可使用，但只有当患者进行监测，每6至12个月，以确定治疗失败，根据其在3月的加拿大胃肠病学杂志“上的报告。

测试与高架低价竞标，所有患者可确定肝炎
卫生保健提供者往往没有屏幕乙型和丙型肝炎，这是为什么70％的人感染丙肝病毒和乙肝病毒感染者约60％不知道他们被感染，仍然是未经处理的高风险患者。

肝炎病毒感染的迹象之一是ALT水平升高。这些肝酶增加，高于正常肝细胞受损和死亡。

荷兰研究人员决定病毒性肝炎ALT升高筛选初级护理的病人，如果是值得的。

他们从患者的ALT水平轻度升高（30-50 IU / L），中度升高（50-70国际单位/升，和批判性升高（70-100 IU / L）筛选了750个血液样本，然后，他们测试的样本HCV和HBV。

他们发现，人与50-100 IU / L，ALT水平，有C型肝炎的感染率比一般人群高十倍。没有确定一个高于正常率，乙肝病毒在患者的ALT水平升高。

作为一个结果，根据研究人员在英国全科医学杂志写的，“......后续丙型肝炎病毒是在这些患者中表示，即使其他ALT升高的解释是。”

只有34％的老人可以成功抗乙肝免疫
最近，流行病学家已经确定在长期护理设施，由于不当的糖尿病检测设备的再利用B型肝炎暴发。

以确定如何将有效的免疫，疾病预防控制中心的研究人员接种的老年人（平均年龄79.5，56％为女性，51％的非洲裔）B型肝炎，然后筛选他们，看看他们是否有足够的抗体来抵御感染。

根据他们的报告发表在三月号杂志疫苗，只有29（34％）的86居民收到的所有三个疫苗成功和发展足够的B型肝炎表面抗体，以防止感染。

“有疫苗反应没有显着性差异，年龄，性别，种族，糖尿病状况，身体质量指数，或目前的吸烟状态，”他们写道。 “我们的研究结果表明，接种乙肝疫苗后，一个熟练的护理设施居民的低比例达到1 seroprotective响应。”

肝硬化和肝癌的发病表面抗原下降
具有讽刺意味的是，乙肝表面抗原在乙肝患者下降的血液循环，为他们发展为肝硬化和肝癌，根据中医杂志中华肝脏病杂志志发表的一份报告金额。

47慢性乙型肝炎患者，72例肝硬化患者和54肝癌患者中HBsAg和HBV DNA水平进行了监测。

平均HBsAg水平：

减少IU /毫升在慢性乙型肝炎患者从2,361.10 1,001.64肝硬化患者IU / ml和下降至594.35 IU /毫升肝癌患者。
在HBeAg阳性患者中，HBsAg的下降从3259.83 IU /毫升的慢性乙型肝炎患者1,077.30 IU /毫升肝硬化组和肝癌组中以789.72 IU /毫升。
在HBeAg阴性患者中，乙肝表面抗原下降IU /毫升在慢性组从1,669.00 1,001.64 IU /毫升在肝硬化组和582.05 IU /毫升癌症组。

ALT升高水平不准确的预测性肝损伤
1994年和2008年间，香港的研究人员进行肝活检，319未经治疗的乙肝患者ALT水平和肝功能损害之间的关系研究。

在这项研究中，211例HBeAg阳性和108 HBeAg阴性，31日的平均年龄46岁，分别。

40九（22.5％）HBeAg阳性患者ALT正常（30 U / L，男性，19的U /大号妇女）有显着性肝损伤。

年龄，谷草转氨酶（表明肝脏健康的另一种酶）和血小板计数与ALT水平升高的HBeAg阳性患者中有显着纤维化的良好指标。

在HBeAg阴性患者中，病毒载量和血小板计数为更好地预测肝功能损害。

ALT水平升高并不总是准确预测无论HBeAg阳性或阴性患者的肝功能损害或显着纤维化之间存在显着的是。

事实上，有中度ALT升高的患者纤维化无显着差异（一到两个倍正常上限）和两倍以上，正常的HBeAg阳性和阴性感染上层人士，根据香港研究人员的报告发表在期刊PLoS。

他们得出结论说，“ALT升高不准确预测显着的肝损伤。”他们指出，医生应该考虑开始治疗的决定时，比刚才的ALT。

乙型肝炎患者的三分之一忘记以他们的日常抗病毒药物
一个在世界肝脏病杂志最近的一篇文章表明，许多乙肝患者往往忘记他们的日常抗病毒药丸。重要的是定期采取抗病毒药物，因为依从性差，可导致病毒抗药性的发展。

澳大利亚研究人员询问他们在抗病毒药坚持的一项调查显示，80例发现，只有66％的规定，而25（33.8％）报道，他们常常忘了他们的药物吃了药。引病人最常见的原因是健忘，用完的药物，是太忙了，并在日常最近发生的变化。

“坚持率分别比医生预计的少得多，并具有潜在的不利影响长期结果，”医生说。

新的microRNA测试非常有效识别肝癌
今天，甲胎蛋白（法新社）对血液样本进行测试是用来确定肝癌最常见的测试 - 但它无法识别在所有患者中近一半的癌症。

利用微RNA（miRNA）的小分子RNA可以预示肿瘤的存在 - 一个新的测试似乎更准确，并有可能最终取代法新社测试，根据在网上杂志“英国医学杂志公开赛的报告。

研究人员测量和比较在57例肝癌，29 B型肝炎患者，以及在中国的30名健康人的miRNA。

miRNA的是肝癌的一种有效的生物标志物，并显着下降后，患者手术切除的肝脏肿瘤，确认肿瘤产生的miRNA。

miRNA的测试发现，96.7％的情况下，癌症，而法新社测试只有50％的有效。新的测试发现非常早期的由法新社测试完全错过了癌症。

作者: 0914 时间: 2012-4-3 18:54

关于干扰联合核苷的方法，以前都认为1+1小于2，怎么现在看起来又要推翻这种观点了呢？？？？？为什么？？？

作者: 0914 时间: 2012-4-3 19:25

“Researchers reported in the March issue of Hepatology that patients who had HBsAg levels less than 200 IU/mL, and who had regular reductions in HBsAg of 50% annually may clear HBsAg within three years."不知道干扰素到这种效果是不是也适用？？？？

作者: 0914 时间: 2012-4-3 19:28

”Elevated ALT Levels Do Not Accurately Predict Liver Damage“ http://www.hbvhbv.com/forum/thread-1112242-1-1.html这是我的情况，，该不该开始抗病毒呢？？？

作者: StephenW 时间: 2012-4-3 20:11

本帖最后由 StephenW 于 2012-4-3 20:12 编辑

0914 发表于 2012-4-3 19:28
”Elevated ALT Levels Do Not Accurately Predict Liver Damage“ http://www.hbvhbv.com/forum/thread ...

我也搞不明白这篇论文。我看了好几遍。
我同意，单一个的ALT测量不能确定你的肝脏状态。如果ALT水平持久高的呢？论文没有说。
也可能ALT水平和肝脏损害水平之间没有线性关系(linear)。再次，论文没有说。

我不喜欢这样的论文。

作者: StephenW 时间: 2012-4-3 20:27

0914 发表于 2012-4-3 18:54
关于干扰联合核苷的方法，以前都认为1+1小于2，怎么现在看起来又要推翻这种观点了呢？？？？？为什么？？？ ...

看看这一个:
[attach]293893[/attach]

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