HBV Journal Review October 1, 2011, Vol 8, no 10 by Christine M. Kukka

StephenW

http://www.hbvadvocate.org/news/HBJ8.10.htm

Young, Hepatitis B Patients Who Smoke Are at Higher Risk of Liver Cancer
吸烟的年轻B型肝炎患者,
肝癌的风险较高

                  Most cases of liver cancer are found in  people infected with the hepatitis B virus (HBV) when they are older than age  40 (in men) or 50 (in women.) However, a new study of Asian-Americans suggests  that younger people under age 40 may be at increased risk of “early onset”  liver cancer if they smoke and have a family history of liver cancer.
                   This finding may be a wake-up call to  doctors to screen younger patients who smoke more often for liver cancer.  Current medical guidelines recommend frequent liver cancer screening for older  patients—not men under age 40 or women under age 50.
                   New York researchers examined liver cancer  in HBV-infected Asian-Americans of all ages to see what increased the risk of  “early onset” liver cancer.
                   They collected data on all Asian immigrants  with hepatitis B treated at Bellevue Hospital Center between 2003 and 2009.  They found 168 cases of liver cancer, with 74% found in older patients and 26%  in younger patients—men under 40 and women under 50.
                   Each age group was compared with similarly-aged hepatitis B patients who were cancer-free. They found male gender and the  presence of cirrhosis (severe scarring of the liver from the infection), increased  the risk of liver cancer in older patients.
                   When younger liver cancer patients were  compared with younger cancer-free patients with hepatitis B, researchers found  that a family history of liver cancer and smoking increased liver cancer rates.
                   Surprisingly, cirrhosis did not lead to  cancer in this younger group, as it did among the older patients, according to  the report published in the American Journal of Gastroenterology.
                   The study suggests that younger Asian HBV  patients who smoke or have a family history of liver cancer are at higher risk  of cancer and should be screened more frequently for liver cancer regardless of  their young age.




(6.合.彩).足球.篮球...各类投注开户下注

第一投注.现金网:招代理年薪10万以上:6668.cc

StephenW

High  Doses of Lamivudine Effective in Patients with HBV-Related Cirrhosis
高剂量的拉米夫定在HBV相关性肝硬化患者有效

                    The antiviral  lamivudine (Epivir-HBV) has fallen out of favor as an antiviral treatment for  hepatitis B because it causes drug resistance.
                   However, a study  reported in the Digestive Diseases and Sciences found the antiviral was  effective when administered in high doses in patients with cirrhosis.
                   Researchers  treated six people with HBV-related cirrhosis with lamivudine doses raised from  the normal dose of 100 mg daily to 200 or 300 mg daily, based on their viral  load. Previously, nearly all of these patients had developed lamivudine  resistance at the lower, 100 mg-dose, and had failed to improve even after the  antiviral adefovir (Hepsera) (10 mg daily) was added to their ongoing  lamivudine treatment.
                   The  HBeAg-negative patients continued to receive adefovir, but the lamivudine dose  was hiked for 12 months. All achieved a “significant” decrease in HBV DNA,  three of the patients achieved undetectable viral load within six months. All  achieved normal ALT levels, indicating no liver damage. The higher dose did not  adversely impact their kidney function, nor were any other side effects noted.
                   The researchers  suggested that increased doses of any antiviral—not just lamivudine—may be  effective in hard-to-treat patients with life-threatening cirrhosis or liver  damage.

StephenW

New  Tests Effective in Identifying Liver Inflammation
   
有效确定肝脏炎症的新的考验。


                    ALT  levels—measured in a blood sample—can reveal if there is liver damage  occurring, but scientists are finding this test can give an unreliable picture  of your liver’s health. The test gives only a momentary “snapshot” of your  liver, and does not show previous damage or fibrosis.
                   Now researchers  think they may have two more reliable tests to show if a liver is inflammed.  Scientists, writing in the journal Liver International, report that  aspartate aminotransferase(AST) and apolipoprotein A1 levels, measured in a  blood sample, can be used to predict moderate liver damage and inflammation,  which if untreated over time can lead to cirrhosis or liver cancer.
                   They performed  these two tests on 227 patients with either hepatitis B or C, who had normal or  only mildly elevated ALT levels, and then performed liver biopsies to confirm  their findings.
                   They found that  48 (21.1%) and eight patients (3.5%) had serious grade 3 and 4 inflammation  respectively. They conducted a wide variety of tests on the patients and found  that the AST and apolipoprotein A1 levels measures most accurately indicated if  serious inflammation was present – even more so than ALT.
                   “Using AST and  apolipoprotein cut-off values of 44 IU/L or higher and 00ng/ml or higher,  respectively, the presence of significant inflammation was predicted with high  specificity (of 96.5%),” they wrote.

StephenW

Breastfeeding by HBV-Infected Mothers  Pose No Risk to Babies
HBV感染的母亲哺乳，不构成任何婴儿的风险

                    A study published in the Archives of  Pediatrics and Adolescent Medicine confirms that breastfeeding by  HBV-infected mothers does not transmit the infection to their babies.
                   Researchers reviewed 10 studies of 751 infants, born to HBV-infected mothers, who  were breastfed and 873 infants who were not breastfed. All babies were  immunized at birth.
                   They concluded that, “Breastfeeding after  proper immunoprophylaxis (immunization) did not contribute to mother-to-child  transmission of HBV.”

baobao7676

回复 StephenW 的帖子

Steven, 能把这篇文章找出来吗？ 全文翻译一下可以破除多少人对乙肝的恐惧？ 功德无量啊！

StephenW

baobao7676 发表于 2011-10-11 23:54
回复 StephenW 的帖子

Steven, 能把这篇文章找出来吗？ 全文翻译一下可以破除多少人对乙肝的恐惧？ 功德无 ...

当然，下面是论文摘要:


ONLINE FIRST
Breastfeeding of Newborns by Mothers Carrying Hepatitis B VirusA Meta-analysis and Systematic Review
Zhongjie Shi, MD; Yuebo Yang, MD; Hao Wang, MD; Lin Ma, MD; Ann Schreiber, BSN; Xiaomao Li, MD; Wenjing Sun, MD; Xuan Zhao, RN; Xu Yang, MD; Liran Zhang, MD; Wenli Lu, MD; Jin Teng, MD; Yufang An, MD

Arch Pediatr Adolesc Med. 2011;165(9):837-846. doi:10.1001/archpediatrics.2011.72
Objective To perform a systematic review of prospective studies to confirm the role of breastfeeding in mother-to-child transmission (MTCT) of hepatitis B virus (HBV).
Data Sources A database was constructed from MEDLINE, EMBASE, Cochrane Library, National Science Digital Library, and China Biological Medicine Database and through contact with experts in this field from January 1, 1990, to August 31, 2010.
Study Selection All studies were peer reviewed and met the preset inclusion standards.
Main Exposure Breastfeeding.
Main Outcome Measures Data regarding HBV intrauterine infection, MTCT, maternal blood and breast milk infectiousness, infant immunoprophylaxis methods and response, and adverse events. The Mantel-Haenszel fixed-effects model was used for all analyses using odds ratios and 95% confidence intervals.
Results Ten qualified studies were included. All were clinical controlled trials, involving 751 infants in the breastfeeding group and 873 infants in the nonbreastfeeding group. As indicated by infant peripheral blood hepatitis B surface antigen or HBV DNA positivity at age 6 to 12 months, the odds ratio of MTCT of HBV in the breastfeeding group compared with that in the nonbreastfeeding group was 0.86 (95% confidence interval, 0.51-1.45) (from 8 clinical controlled trials, P = .56; I2 = 0%, P = .99). As indicated by infant peripheral blood hepatitis B surface antibody positivity at age 6 to 12 months, the odds ratio of development of hepatitis B surface antibodies in the breastfeeding group compared with that in the nonbreastfeeding group was 0.98 (95% confidence interval, 0.69-1.40) (from 8 clinical controlled trials, P = .93; I2 = 0%, P = .99). No adverse events or complications during breastfeeding were observed.
Conclusion Breastfeeding after proper immunoprophylaxis did not contribute to MTCT transmission of HBV.

Author Affiliations: Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou (Drs Shi, Y. Yang, Ma, and Li), and Department of General Surgery, The Second Affiliated Hospital (Dr Wang) and Laboratory of Medical Genetics (Dr Sun), Harbin Medical University, and Heilongjiang Academy of Traditional Chinese Medicine (Ms Zhao and Drs X. Yang, Zhang, Lu, Teng, and An), Harbin, People's Republic of China; and Department of Chemistry (Dr Shi) and Health Science Center (Dr Ma and Ms Schreiber), Temple University, Philadelphia, Pennsylvania.