HBV Journal Review January 1, 2012, Vol 9, no 1 by Christine M. Kukka

StephenW

HBV Journal Review
January 1, 2012, Vol 9, no 1
by Christine M. Kukka
Livers Previously Infected with HBV Can Be Safely Used in Transplants
Because of the scarcity of available livers for organ transplants, researchers have wondered if livers from people with resolved hepatitis B infections could be used.

U.S. researchers studied the outcomes between transplant patients who received uninfected livers to those who received livers that were hepatitis B core antibody-positive (HBcAb) and who additionally were treated with antivirals and hepatitis B antibodies (hepatitis B immune globulin-HBIG) in order to decrease risk of reinfection.

They followed 25 liver transplants with prior infections. Those who received the previously-infected livers tended to have more serious liver disease at the time of the transplant.

However, all patients receiving these livers were treated with long-term antivirals as well as HBIG and none of them developed hepatitis B. Overall survival at 30 days, 1 year and 5 years was 92%, 74% and 74%, respectively, which was comparable to 96%, 89% and 76% in the control group.

Researchers, writing in the January 2021 issue of The International Journal of the Hepato Pancreato Biliary Association, determined that using HBcAb-positive livers was safe.

Transplant Patients Who Keep Viral Loads Low with Antivirals Have High Survival Rates
Researchers, studying the effect of antivirals on hepatitis B liver transplant patients, found that liver cancer patients who maintained low levels of HBV DNA (viral load) during and after the liver transplant had the highest rates of survival.

According to the report published in the December 2011 issue of the Journal of Hepatobiliary Pancreatic Sciences, doctors followed 70 transplant patients. They found the group that had high HBV DNA levels (more than 10,000 copies/mL), and who were not treated with antivirals had worse outcomes.

“Tumor-free survival rate was significantly higher in the antiviral therapy group than in the high viral group,” they wrote. As expected, the presence of multiple tumors prior to the transplant decreased survival rates.

The study suggests that treating hepatitis B transplant patients with antivirals is critical to keep liver cancer from recurring.
以前乙型肝炎病毒感染的的肝移植可以安全地使用在
由于器官移植肝脏的稀缺，研究人员想知道，如果从解决的B型肝炎感染的人的肝脏可以用来。

美国研究人员研究了那些接受肝，乙肝核心抗体阳性（大三阳），此外，与抗病毒药物和B型肝炎抗体（乙肝免疫球蛋白，HBIG）治疗，以收到未受感染的肝移植患者之间的成果减少重复感染的风险。

他们随后与以前感染的25例肝脏移植手术。那些以前感染的肝移植时往往有更严重的肝脏疾病。

然而，所有这些肝患者接受治疗与长期的抗病毒药物以及乙型肝炎免疫球蛋白和他们没有开发出B型肝炎的整体存活30天，1年和5年为92％，74％和74％，分别，这96％，89％和76％，对照组相比。

研究人员，写作，在2021年的1月国际肝胰胆协会杂志“的问题，使用大三阳阳性的肝脏是安全的。

谁保持与抗病毒药物的病毒载量低的移植患者存活率高
研究人员，研究的抗病毒药物对乙肝肝移植患者的影响，发现谁的肝脏移植手术期间和之后保持低HBV - DNA（病毒载量）水平的肝癌患者生存的最高利率。

据肝胆胰腺科学“杂志在2011年12月发表的报告，医生随后70移植患者。他们发现了高HBV DNA水平（超过10000拷贝/ ml）组，并没有用抗病毒药物治疗有更糟糕的结果。

，“他们写道：”在抗病毒治疗组无瘤生存率显着高于高病毒组。正如预期的那样，存在多种肿瘤的移植前降低存活率。

这项研究表明，与抗病毒药物治疗B型肝炎移植患者保持经常性肝癌的关键。

StephenW

Older Age, Low Viral Load Increases Chance of Spontaneous HBsAg Clearance
Each year, between 0.5% and 2.26% of people with chronic hepatitis B are able to get rid of HBsAg spontaneously, without treatment. Researchers have long wondered what predisposes some people to clearing the virus on their own.

South Korean researchers, writing in the December issue of the journal Digestion, followed HBV DNA levels in 880 patients who tested negative for the hepatitis B e antigen (HBeAg), to see which ones cleared HBsAg spontaneously, and what conditions might lead to the event.

They chose HBeAg-negative patients (average age was 50) because they tended to have lower viral loads and had better chances at clearing the virus.

Over 31 months, researchers found 1.8% of the studied patients cleared HBsAg. Those who cleared the virus tended to be older and had lower HBV DNA levels--under 2,000 IU/ml.

年龄较大，低病毒负荷增加自发HBsAg清除的机会
每一年，都能够清除乙肝表面抗原自发的，没有接受治疗，慢性乙型肝炎患者的0.5％和2.26％之间。研究人员一直想知道什么诱发一些人自行清除病毒。

韩国研究人员，在12月的杂志消化问题的书面，HBV DNA水平测试B型肝炎e抗原（HBeAg）阴性的880例患者中，看到哪些清除乙肝表面抗原自发，什么条件下可能会导致事件。

他们选择HBeAg阴性患者（平均年龄是50岁），因为他们往往有降低病毒载量和清除病毒有更好的机会。

超过31个月，研究人员发现，清除乙肝表面抗原研究的患者的1.8％。那些被清除的病毒往往是老年人和HBV DNA水平较低 - 在2000 IU / ml的。

StephenW

As Expected, Getting Hepatitis A on Top of HBV Increases Liver Failure Risk
While experts assume getting a second liver infection on top of a hepatitis B infection is bad, South Korean researchers decided to find out exactly how serious a hepatitis A infection would be on top of a HBV infection. Hepatitis A is generally transmitted through contact with feces or consuming uncooked shellfish exposed to raw sewage.

They scoured the medical records of 449 patients hospitalized for acute hepatitis A, and found 30 who were HBsAg-positive at the time of their hepatitis A infection.

According to their report in the December issue of the journal Gut Liver, the HBsAg-positive group suffered far more liver health problems at their time of their hospitalization for hepatitis A.

They had higher rates of gastrointestinal bleeding, acute renal (kidney) failure, and acute liver failure. In particular, liver failure rates were nine-fold higher in the

HBsAg-positive group than in the HBsAg-negative group (23.3% vs. 3.3%).

正如所料，入门型肝炎对HBV的顶一个，提高肝功能衰竭的风险
虽然专家们假设B型肝炎感染上乙肝感染是坏的，韩国的研究人员决定找出一个感染上了乙肝病毒感染的顶部到底有多严重型肝炎。 A型肝炎通常是通过接触传播，接触到未经处理的污水的粪便或食用未煮熟的贝类。

他们走遍了449例急性A型肝炎住院的病历，发现30谁是在A型肝炎感染时表面抗原阳性。

根据他们在12月的杂志肠肝问题的报告，乙肝表面抗原阳性组在其住院时遭受甲型肝炎肝健康问题更为

他们的消化道出血，急性肾功能衰竭（肾），急性肝功能衰竭的比率较高。尤其是肝功能衰竭率分别在高9倍

HBsAg阳性组比HBsAg阴性组（23.3％对3.3％）。

StephenW

Even Prednisone Increases Risk of HBV Reactivation
Increasingly, doctors are finding even low-dose medications used to suppress the immune system for common ailments, such as prednisone (similar to cortisone) used to treat arthritis and other allergic conditions, can cause hepatitis B to reactivate, even in people with resolved or inactive HBV infections.

Researchers, writing in the Dutch medical journal Ned Tijdschr Geneeskd, reported on two patients—a 55-year-old woman and 71-year-old man—treated with prednisone for facial paralysis and rheumatoid arthritis.

Experts recommended that all such patients identified for prednisone treatment be screened for hepatitis B and then treated with antivirals during steroid treatment to prevent liver damage resulting from hepatitis B reactivation.

即使泼尼松HBV再激活的风险增加
越来越多，医生发现即使是低剂量的药物用于抑制免疫系统的常见疾病，如强的松（类似可的松），用于治疗关节炎和其他过敏性疾病，可导致乙型肝炎重新激活，甚至可以用解析或的人非活动乙肝病毒感染。

的研究人员，在荷兰医学杂志斯内德Tijdschr Geneeskd写作，两个病人，一个55岁的女人和71岁的男子治疗面瘫，类风湿关节炎强的松。

专家建议乙肝强的松治疗找出所有此类患者进行筛选，然后在类固醇治疗，以防止从B型肝炎活化导致的肝功能损害与抗病毒药物治疗。

StephenW

Widespread Pegylated Interferon Treatment Confirms Drug’s Effectiveness
While pegylated interferon (Pegasys) has been studied in clinical trials, Australian researchers checked on the effectiveness of the drug in real life treatment centers to see if the treatment success found in clinical studies would be duplicated in the field.

Pegylated interferon is a time-release interferon, requiring a weekly injection, which boosts the immune system to fight HBV infection. Generally, it is give for about 48 weeks, and unlike oral antivirals, the treatment does not have to continue indefinitely and it does not lead to drug resistance. It is one of the first treatment options recommended to people newly diagnosed with hepatitis B.

In this study, published in the Journal of Gastroenterology and Hepatology, researchers followed 29 HBeAg-negative patients and 63 HBeAg-positive patients treated with interferon at five medical centers. Most had high viral loads and signs of liver damage.

After six months of interferon treatment, among those who were HBeAg-positive:

    46% achieved normal alanine aminotransferase (ALT), which indicates no liver damage
    16% had undetectable viral loads
    And 32% lost HBeAg and developed “e” antibodies (called HBeAg seroconversion)

Among the 29 HBeAg-negative patients treated, 48% had high viral loads and 24% had advanced fibrosis. Six months after treatment ended:

55% and 36% respectively maintained normal ALT levels and undetectable viral loads.

Between 50% to 75% of all patients maintained low viral loads and healthy ALT levels over the two-year follow-up period.

The researchers concluded that even in everyday clinical practice, pegylated interferon was effective and well-tolerated, with only 6% stopping treatment because of side effects from the medication, which can include body aches and depression.

广泛的聚乙二醇干扰素治疗，确认药物的效果
聚乙二醇化干扰素（派罗欣）虽然已在临床试验研究，澳大利亚研究人员在现实生活中的治疗药物的有效性检查中心在临床研究中发现，如果治疗成功，将在该领域重复。

聚乙二醇干扰素是一个时间释放干扰素，需要每周注射，增强免疫系统来对抗乙肝病毒感染。一般来说，它是给约48个星期，不像口服抗病毒药物，治疗没有无限期地继续下去，它不会导致耐药。这是建议先治疗新诊断与B型肝炎的人的选项之一

在这项研究中，研究人员随后发表在“胃肠病学和肝病杂志”，29 HBeAg阴性患者和63例干扰素治疗HBeAg阳性患者在5个医疗中心。大多数高病毒载量和肝功能损害的迹象。

干扰素治疗6个月后，那些HBeAg阳性：

    46％，达到正常丙氨酸转氨酶（ALT），这表明没有肝功能损害
    16％已测不到病毒载量
    和32％失去了HBeAg和开发的“E”的抗体（称为HBeAg血清学转换）

在29 HBeAg阴性治疗的患者中，48％的高病毒载量和24％的晚期肝纤维化。 6个月后，治疗结束：

分别为55％和36％，保持正常的ALT水平和检测不到病毒载量。

所有患者的50％至75％，继续保持低病毒载量超过两年的随访期间，健康的ALT水平。

研究人员得出结论，即使在日常临床实践中，聚乙二醇干扰素是有效和耐受性良好，只有6％，其中可以包括身体疼痛和抑郁症的药物因为副作用停止治疗。

StephenW

Extending Treatment or Adding Antivirals Increases Interferon’s Effectiveness
Chinese researchers followed 92 patients treated with pegylated interferon who initially did not respond to interferon treatment to see if extending treatment or adding antivirals boosted its effectiveness.

According to the report published in the Chinese medical journal, Zhonghua Gan Zang Bing Za Zhi, researchers tried:

    Extending interferon treatment from 48 to 72 weeks
    Adding antivirals—either entecavir (Baraclude) or adefovir (Hepsera)—to the ongoing interferon treatment.

Researchers reported that patients with extended interferon treatment had a significantly higher response rate (78.3%) than patients who received only 48 weeks of treatment.

Patients who received antivirals in addition to interferon experienced three-fold reductions in viral load.

“Individualizing therapy by prolonging the duration of (interferon) treatment to 72 weeks or adding (antivirals) such as entecavir and adefovir in patients without early response may substantially increase the sustained viral response rate and lead to the decrease of HBsAg,” they wrote.

延长治疗或添加抗病毒药物，增加干扰素的成效
中国研究人员随后与聚乙二醇干扰素谁最初没有回应干扰素治疗，看看是否延长治疗或加入抗病毒药物，增强其有效性治疗的92例。

据中国医学杂志，中华肝脏病杂志发表的报告，研究人员试图：

    从48到72周延长干扰素治疗
    添加抗病毒药物恩替卡韦（博路定）或阿德福韦（Hepsera）正在进行的干扰素治疗。

研究人员报告说延长干扰素治疗的患者有显着较高的反应率（78.3％）比只有48个星期的治疗，患者谁收到。

除了干扰素抗病毒药物的患者谁收到经历病毒载量的3倍的减少。

“个体化治疗延长期限（干扰素）治疗72周或恩替卡韦和阿德福韦的患者如不及早应对加入（抗病毒药物）可能大幅增加的持续病毒反应率，导致HBsAg的下降，”他们写道。

StephenW

Interferon Treatment Appears to Be Safe in Pregnant Women
A team of Canadian researchers have found that interferon alpha treatment in women who have liver disease from hepatitis B or C, or thrombocythemia (ET)—the presence of high platelet counts in the blood—is safe.

The University of Toronto researchers examined reports on 63 pregnant women who were treated with interferon during their pregnancy. No cases of malformations or stillbirths were reported. There was one miscarriage and 13 premature deliveries (20% of all cases).

“The results of our systematic review suggest that interferon does not significantly increase the risk of major malformation, miscarriage, stillbirth or preterm delivery above general population rates,” researchers wrote in the December 2011 issue of the journal of Reproductive Toxicology.

干扰素治疗，似乎是在孕妇安全
一个加拿大的研究人员小组发现，α-干扰素治疗妇女有乙型或丙型肝炎的肝脏疾病，或血小板增多症（ET）在高血小板计数存在血液安全。

大学多伦多研究人员研究了63谁是干扰素治疗怀孕期间孕妇的报告。畸形或死胎无病例报告。有一个流产和13早产（20％的情况下）。

“我们的系统的审查结果表明，干扰素并不显著增加主要畸形，流产，死胎或早产高于一般人群率的风险，”研究人员写道：在2011年12月的生殖毒理学“杂志的问题。

StephenW

Plant Ribosomes May Help Halt HBV Replication One Day
Ribosomes--tiny structures in cells that convert RNA into protein—from plants may be useful in combating HBV and HIV infections one day, according to a report by Indian researchers published in the December issue of the Chinese medical journal Virologica Sinica.

The researchers found that the ribosome inactivating proteins (RIPs) inhibit replication of HIV, HBV and even herpes simplex viruses.

“Recently, Phase I/II clinical trials have demonstrated the potential use of RIPs for treating patients with HIV disease,” they noted.

植物核糖体可能帮助制止乙肝病毒复制的一天
核糖体 - 蛋白质的微小结构，转换成RNA的细胞，从植物可能有助于防治乙肝病毒和艾滋病毒感染有一天，根据印度研究人员在12月的中国医学杂志“病毒学学报发表的报告。

研究人员发现，核糖体失活蛋白（RIPS）抑制艾滋病毒，乙肝病毒的复制和甚至单纯疱疹病毒。

“最近，I / II期临床试验已显示出潜在的治疗HIV疾病患者的RIP的使用，”他们指出。

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