肝胆相照论坛
标题: HBV杂志回顾 2015年6月1日，第12卷，没有6 恭M. Kukka [打印本页]
作者: StephenW 时间: 2015-6-4 15:05 标题: HBV杂志回顾 2015年6月1日，第12卷，没有6 恭M. Kukka
HBV Journal Review
June 1, 2015, Vol 12, no 6
by Christine M. Kukka
PDF (download)
HBV Liver Cancer Requires Aggressive Treatment from the Start
Today, doctors use a one-size-fits-all approach to treating liver cancer no matter if it results from hepatitis B or C. However, a new study finds that liver cancer caused by the hepatitis B virus (HBV) requires an aggressive treatment plan.
These findings, presented at the American Society of Clinical Oncology meeting in May, may lead doctors to develop a more accelerated treatment plan for HBV-related liver cancer.
Researchers reached this conclusion after monitoring disease progression and survival rates in 815 liver cancer patients infected with either HBV or the hepatitis C virus (HCV) treated at their University of Texas M. D. Anderson Cancer Center between 1992 and 2011.
HBV (a DNA virus) and HCV (an RNA virus) infect the liver differently. The researchers found HBV patients developed liver cancer at a younger age and had a more aggressive cancer.
When compared to hepatitis C patients, HBV patients:
- Had higher levels of alpha-fetoprotein (AFP), found through a blood test, which indicates the presence of tumors
- Had liver cancer tumors that grew and spread more quickly
- Had larger tumors
- And often had portal thrombosis–a blockage of the vessel that delivers blood to the liver from the intestines.
However, hepatitis C patients with liver cancer had higher rates of cirrhosis, histories of alcohol and cigarette use and more diabetes than hepatitis B patients.
The average survival rate for hepatitis B patients was 9.3 months after liver cancer diagnosis, compared to 10.9-month survival for hepatitis C patients.
According to a related editorial published in the medical journal Oncology, about 700,000 patients are diagnosed with liver cancer each year worldwide; more than two-thirds of new cases result from HBV infection.
Knowing HBV-related liver cancer is more aggressive can lead to different or accelerated treatment plans when patients are first diagnosed, the study's experts suggest.
“This study provides more evidence that future clinical trials should stratify patients by hepatitis type to help identify better drugs and create personalized treatment modalities,” researcher Ahmed Kaseb explained.
Source: http://newswise.com/articles/variations-in
-liver-cancer-attributable-to-hepatitis-virus-variations
Experts: Treat Cirrhotic Patients, Even if Viral Load Is Low
Should "healthy" patients who have cirrhosis with low viral load and no signs of liver damage be treated? Absolutely, according to experts writing in the May issue of the medical journal Hepatology.
Today, there are no clear medical guidelines dictating whether patients with "compensated cirrhosis" should be treated. These patients have liver scarring and fibrosis, but not severe enough to impede their liver function. They can have low viral load (HBV DNA) and normal alanine transaminase (ALT) levels, which indicate no liver damage.
Despite those healthy signs, Korean researchers contend these patients remain at high risk of liver cancer and do require treatment.
They followed 385 untreated patients with seemingly benign cirrhosis (average age 51, 66% male) for nearly six years and discovered 9.6% developed liver cancer despite their low viral loads. Researchers determined the five-year risk of liver cancer in these patients was:
- 2.2% in patients with undetectable viral load
- 8% in patients with low viral load and normal ALT levels
- And 14% in patients with low viral load but elevated ALT levels.
During the six-year study's follow-up period, 126 patients had increases in their viral load exceeding 2,000 IU/mL; 77 of these patients were treated with antivirals.
- The patients treated with antivirals had liver cancer rates of 1.4%
- Untreated patients who continued to have low viral load had cancer rates of 8.8%.
- And untreated patients with viral load spikes had liver cancer rates of 13.3%.
"Compensated cirrhosis patients with detectable but low viral load were not at low risk for liver cancer, and (antiviral treatment) was associated with lower liver cancer risk, suggesting that prompt (antiviral treatment) should be considered for these patients," researchers wrote.
Source: www.ncbi.nlm.nih.gov/pubmed/25963803
?dopt=Abstract
Some Patients Can Safely Stop Antiviral After Four Years
German researchers followed 21 middle-aged patients who stopped treatment with the antiviral tenofovir (Viread) after four years and found that most did well, with two patients even losing the hepatitis B surface antigen (HBsAg).
All study participants had HBeAg-negative hepatitis B (testing negative for the hepatitis B "e" antigen). All maintained undetectable viral loads and normal ALT levels, indicating no liver damage, during their four years on tenofovir.
After stopping tenofovir, only three of the 21 patients had to restart tenofovir due to rising viral loads and liver damage.
The overall study involved 42 patients, 21 of whom were taken off tenofovir and 21 who continued on tenofovir and served as the control group. Both groups were similar in age and most were male.
According to the report presented at the 50th European Association for the Study of the Liver (EASL) conference, all patients in the stop-tenofovir group developed detectable levels of HBV DNA, but nearly all maintained low HBV DNA levels under 2,000 IU/mL. These patients also had moderate increases in their ALT levels, except for the three patients who were restarted on tenofovir.
What was significant is the stop-tenofovir group had notable declines in their HBsAg levels after stopping treatment. Two of the patients lost HBsAg completely, indicating they developed an "inactive" infection that posed little risk of liver damage.
In contrast, none of the 21 control group patients who continued on tenofovir had any declines in their HBsAg levels.
While it remains unclear exactly when patients can be safely taken off antivirals, this study found that nearly all patients taken off tenofovir after four years of undetectable viral load and no liver damage remained healthy and did not need additional treatment.
Source: www.firstwordpharma.com/node/1279476
#axzz3bC1YUS2C
Tenofovir Safe and Effective in Pregnant Women with Drug Resistance
Tenofovir also proved very effective in lowering viral load and preventing infection of newborns in 48 pregnant women with HBV who had developed resistance to the antiviral drug lamivudine (Epivir-HBV) prior to their pregnancies.
According to the study presented at the EASL, the earlier in the pregnancy that tenofovir was started, the more effective it was in lowering viral load by the time delivery occurred. Infants are at high risk of becoming infected at birth if their mothers have high levels of HBV DNA in their blood and body fluids.
On average, tenofovir lowered the women's viral load five-fold. Researchers in China reported they began administering tenofovir between week 24 and 28 of the pregnancies. Other recent studies have shown that treating pregnant women even earlier in their pregnancies is safe and very effective in lowering viral load.
All newborns were immunized and received HBIG–hepatitis B antibodies–at birth to protect against infection. When tested 12 months after birth, none were found to be infected.
Source: www.firstwordpharma.com/node/1279605
#axzz3bC1YUS2C
Researchers Discover Why Children Become Chronically Infected
Researchers may finally have discovered why newborns and young children are prone to developing chronic hepatitis B infections, while adults usually clear the virus quickly after a brief (acute) infection.
British researchers report that HBV can sneak into the liver and infect cells during early childhood because special suppressor cells designed to protect young livers against inflammation basically shut down immune cells to keep them from attacking and inflaming the HBV-infected liver.
For years, researchers have tried to understand why a young immune system failed to attack an HBV infection of the liver. Because the immune system never responded, HBV was able to reproduce rapidly in the liver. This is called the "immune tolerant" stage of hepatitis B.
Researchers, writing in the May issue of Nature Medicine, suggests that suppressor cells in the liver switch off the immune cells that would normally attack the infection as a way to protect the young liver from inflammation and damage.
“If we could boost the immune system and counteract the liver’s suppressive effect, then the infection could potentially be cleared after a large ‘burst’ of immune activity," researchers suggested. "This might cause short-term damage to the liver, but would prevent the long-term damage from scarring and liver cancers that we see in chronic (hepatitis B) patients.”
In their study, researchers compared blood and liver tissue samples from hepatitis B patients and healthy participants. They found patients in the immune tolerant phase of infection had high levels of granulocytic myeloid-derived suppressor cells (gMDSCs) in their liver. These cells suppress the immune system's fighter T cells by cutting off their food supply.
The suppressor cells subdued both the T cells that would normally target HBV-infected liver cells as well as the T cells that cause inflammation as they eradicate the infected liver cells. Females in the study tended to have higher levels of gMDSCs.
Source: www.nature.com/nm/journal/vaop/ncurrent/full/
nm.3856.html
Expert Recommends Treatment for Mental Confusion from Cirrhosis
Some patients with cirrhosis develop confusion, poor memory, and sleep problems and have trouble driving because their damaged livers cannot screen toxins from their blood that impair brain function.
Hepatitis expert Dr. Robert Gish, writing in the online journal Scribd, recommends a thorough mental and physical exam to diagnosis this affliction, called hepatic encephalopathy.
Diet: Dr. Gish recommends a diet with adequate protein to avoid loss of muscle mass.
Zinc levels should also be measured because low zinc worsens encephalopathy symptoms. Patients with zinc deficiencies should take between 50 to 200 mg per day.
Treatments: Encephalopathy is treated with the antibiotic pill rifaximin (Xifaxan) at a dose of 550 mg daily. This antibiotic was originally developed for diarrhea. Flagyl (Metronidazole) is another antibiotic that helps patients with encephalopathy.
Probiotic supplements: Also recommended are probiotic supplements, which help repopulate the gut with natural bacteria to help it digest food and lower ammonia production. A recent study found probiotics alone (without antibiotics) was effective in preventing development of encephalopathy in 160 cirrhotic patients over a period of nine months.
Probiotics, in capsules, work by enhancing production of certain microorganisms that decrease ammonia production. The study found that twice as many untreated patients developed encephalopathy than did patients taking probiotic supplements.
Do not take Neo-Fradin, Neo-Rx (Neomycin): Another antibiotic, Neomycin, also changes the chemistry and bacteria in the intestine to lower ammonia levels, but it should never be used, Dr. Gish advises. "If this medication is prescribed for more than six months, hearing tests should be performed since there may be a risk of hearing loss. Hearing tests are critical if a patient is using Lasix (Furosemide) along with Neomycin," he writes.
Source: www.scribd.com/doc/265482027/
Hepatic-Encephalopathy
Antivirals Increase Survival After Liver Cancer Treatment
Starting hepatitis B patients who have had liver tumors removed on antivirals increases their survival, especially when patients are treated in the early stages of liver cancer, according to a report published in the Chinese Journal of Cancer.
Researchers followed 224 liver cancer patients who had liver tumors successfully removed using chemoembolization. This method injects chemotherapy directly into a tumor, which starves it by blocking its blood supply.
About half of the patients were treated with antivirals and the other half, the control group, were not. Overall, the group treated with antivirals survived for about 16 months after surgery, compared to a 9.6-month survival rate among untreated patients.
However, survival increased markedly in antiviral-treated patients who were in the early stages of liver cancer. Those who had tumors removed while in the early stages survived for another 62 months with the help of antivirals, compared to a 26.2-month survival rate for untreated, early-stage patients.
In patients with advanced stages of liver cancer, antivirals did not extend survival.
Source: http://7thspace.com/headlines/508704/
impact of oral antihepatitis b therapy on the survival
of patients with hepatocellular carcinoma initially treated
with chemoembolization.html
HBV Patients with Diabetes Have a Higher Risk of Liver Cancer
A new study from Taiwan finds hepatitis B patients who have diabetes or who develop diabetes during their infection are at higher risk of liver cancer.
According to the report, published in the May issue of the journal Alimentary Pharmacology & Therapeutics, researchers compared liver cancer rates in 2,099 hepatitis B patients who had new diabetes diagnoses against 2,080 hepatitis B patients without diabetes.
A higher proportion of patients with diabetes developed liver cancer (3.29%) compared with patients without diabetes (2.02%); researchers reported. Patients with recent diabetes diagnoses also had slightly higher rates of liver cancer.
Diabetic patients often had other health issues, including cirrhosis and obesity.
Because hepatitis B patients with diabetes are at higher risk of cancer, doctors should do everything they can to prevent diabetes development in these patients, and/or carefully monitor patients who develop diabetes while in their care, researchers concluded.
Source: www.healio.com/hepatology/oncology/news
/online /%7B6d308de1-614c-4423-b586-20f01a0e73e6%7D
/diabetes-increases-risk-for-hcc-in-adults-with-hbv
Long-term Antiviral Use Increases Hip Fracture Rates Slightly
To find out if long-term antiviral treatment is safe, Hong Kong researchers compared the health of 46,454 untreated hepatitis B patients against 4,046 patients who were treated with antivirals for five years to see if long-term treatment caused bone loss or kidney problems.
The comprehensive study, reported in the May issue of the journal Hepatology, looked for kidney disease and failure and hip, vertebral and other bone fractures in the participants.
Researchers noted a slight increase in hip fractures among treated hepatitis B patients, but no other bone fractures.
They concluded that antiviral treatment, "...does not increase the risk of renal (kidney) and bone events in general. (Antivirals) may increase the risk of hip fracture, but the overall event rate is low."
Source: www.ncbi.nlm.nih.gov/pubmed/25973979
Second Vaccine Series May Be Needed for Children with Celiac Disease
People with celiac disease–the inability to digest gluten–may require a heptitis B vaccine booster according to a study presented at the 33rd Annual Meeting of the European Society of Paediatric Infectious Diseases.
Researchers monitored 72 children with severe allergies to gluten who received the full three vaccine doses, but who still had hepatitis B antibodies below the recommended 10 mUI/mL, which is needed to protect against infection.
Researchers administered an additional vaccine dose to the children and measured their antibodies six months later. About 85% of the children who received the booster achieved a protective level of antibodies, however the remaining 15% were "non-responders."
Researchers recommended administering a second round of the three-shot vaccine in all children with celiac disease who do not respond to the initial round of immunization shots.
Source: www.firstwordpharma.com/node/1284715
#axzz3bC1YUS2C
Researchers Find HBV B Strain in Cuba Did Not Come from Africa
Because hepatitis B viral strains or genotypes developed over thousands of years in specific regions of the world, their presence in a new location can tell the story of human migrations.
For example, today in West Africa HBV genotype E is the dominant hepatitis B strain. So, scientists expected to find HBV genotype E in Caribbean islands settled by Africans who were brought there during the Transatlantic Slave Trade.
But two studies, one in Haiti and the latest one in Cuba, both failed to find HBV genotype E among the descendants of African slaves who have chronic hepatitis B.
In the May issue of the medical journal PlosS one, researchers examined the HBV genotypes of 172 Cubans. Instead of finding HBV genotype E, which they expected to find, they instead discovered the dominant HBV genotype was A, which originates in Asia and Europe.
The finding is similar to a study in Haiti which also found an absence of genotype E. This means that HBV genotype E was probably introduced to West Africa after the slave trade of the 1700s and 1800s stopped. Similarly, HBV genotype A was probably introduced to Cuba after the slave trade ended.
Source: www.bioportfolio.com/resources/pmarticle/1239701
/Genetic-Diversity-of-the-Hepatitis-B-Virus-Strains-in-Cuba-Absence-of.html
作者: StephenW 时间: 2015-6-4 15:06
HBV杂志回顾
2015年6月1日，第12卷，没有6
恭M. Kukka
PDF PDF（下载）
乙肝肝癌需要从开始积极治疗
今天，医生用一个尺寸适合所有人的方法不管它来自乙肝或丙肝然而结果治疗肝癌，一项新研究发现造成乙肝病毒（HBV）的肝癌患者需要积极治疗计划。
这些研究结果，在临床肿瘤学会议在5月美国社会提出，可能会导致医生制定HBV相关的肝癌更加速治疗方案。
研究人员达到治疗后，在得克萨斯大学的MD Anderson癌症中心1992年至2011年间的监测病情进展和生存率815肝癌患者感染乙肝病毒或者或丙型肝炎病毒（HCV）这一结论。
乙肝病毒（DNA病毒）和HCV（一种RNA病毒）感染肝脏不同。研究人员发现，乙肝患者发展为肝癌在年轻的时候，有一个更具侵略性的癌症。
相较于丙型肝炎患者，乙肝患者：
有较高水平的甲胎蛋白（AFP），通过血液测试，这表明肿瘤的存在下发现
有肝癌肿瘤生长和扩散更迅速
肿瘤较大
而往往有这样的提供血液从肠道的肝血管的血栓门户 - 堵塞。
然而，丙型肝炎肝癌患者患有肝硬化的比率较高，酒精和香烟的使用历史，比乙肝患者更糖尿病。
平均生存率为乙肝患者是肝癌诊断9.3个月后，相比10.9个月的生存率为丙肝患者。
根据发表在医学杂志肿瘤相关评论中，约70例被诊断为全世界每年肝癌;超过三分之二的新发病例是由于HBV感染。
了解乙肝相关的肝癌是更积极的可以导致不同的或加速治疗计划的首诊患者时，该研究的专家建议。
“这项研究提供了更多的证据表明，未来的临床试验应分层患者肝炎类型，以帮助识别更好的药物和创造个性化的治疗方法，”研究员艾哈迈德Kaseb解释。
来源：http://newswise.com/articles/variations-in
- 肝脏肿瘤，由于对肝炎病毒变异
专家：治疗肝硬化的患者，即使病毒载量低
应该谁拥有肝硬化低病毒载量和肝损害迹象“健康”的患者进行治疗？当然，根据专家写在5月发行的医学杂志肝病。
今天，有没有明确的医疗指引口述患者有无“代偿性肝硬化”应及时治疗。这些患者可有肝结疤和纤维化，但不足以严重到阻碍他们的肝功能。它们可以具有低病毒载量（HBV-DNA）和正常丙氨酸转氨酶（ALT）水平，这表明没有肝损伤。
尽管有这些健康的迹象，韩国研究人员争辩这些患者保持在肝癌的高风险，的确需要治疗。
他们随后385例初治的良性看似肝硬化（平均年龄51，66％为男性）近六年，发现9.6％肝脏癌症，尽管他们的低病毒载量。研究人员确定这些患者肝癌的五年风险是：
患者检测不到病毒载量的2.2％
患者的病毒载量低和ALT正常水平8％
和患者病毒载量低但ALT水平升高14％。
在6年的研究的随访期间，126例患者有增加的病毒载量超过2000国际单位/毫升;这些患者77均采用抗病毒药物。
用抗病毒药物治疗的患者有1.4％的肝癌率
未经治疗的病人谁继续有低的病毒载量的8.8％，癌症发病率。
而未经治疗的患者病毒载量峰值有13.3％的肝癌率。
“代偿性肝硬化患者的检测，但病毒载量低并不低风险肝癌和（抗病毒治疗）与较低的肝癌风险，提示提示（抗病毒治疗），应考虑为这些患者，”研究人员写道。
来源：www.ncbi.nlm.nih.gov/pubmed/25963803
？DOPT =摘要
有些患者可以安全地停止抗病毒经过四年
德国研究人员跟着谁四年后停止治疗，抗病毒替诺福韦（Viread的），发现大多数做的很好，有两个病人甚至失去了乙肝表面抗原（HBsAg）21中老年患者。
所有的研究参与者HBeAg阴性乙肝（测试阴性乙肝“e”的抗原）。所有检测不到的保持病毒载量和ALT水平正常，表明无肝功能损害，在对替诺福韦的四年。
替诺福韦停止后，只有三个21例患者不得不重新开始替诺福韦由于上升的病毒载量和肝损害。
整个研究包括42例患者，21人被带下替诺福韦和21谁继续替诺福韦和作为对照组。两组患者的年龄相似，大多数是男性。
据介绍，在50欧洲协会为肝脏（EASL）会议的研究报告，在停止替诺福韦组中的所有病人发生HBV DNA的检测水平，但在2000 IU / mL的几乎所有维持低HBV DNA水平。这些患者也有适度的增加，他们的ALT水平，除了谁是重新启动在替诺福韦的三个病人。
什么是显著是停止替诺福韦组停止治疗后曾在其HBsAg水平显着下降。两名患者的HBsAg失去完全，表明他们开发了造成的肝损害风险不大“不活动”的感染。
相比之下，没有21对照组病人谁继续替诺福韦在他们的HBsAg水平下降的任何。
虽然目前还不清楚什么时候患者可以安全地起飞的抗病毒药物，这项研究发现，几乎所有的患者带下替诺福韦在四年后检测不到病毒载量无肝损害保持健康，并不需要额外的治疗。
来源：www.firstwordpharma.com/node/1279476
＃axzz3bC1YUS2C
替诺福韦安全，有效的孕妇与耐药性
替诺福韦也被证明是非常有效地降低病毒载量和预防新生儿感染在48孕妇乙肝病毒谁制定耐抗病毒药物拉米夫定（拉米-HBV）之前，自己已经怀孕。
根据这项研究在EASL介绍，在怀孕早期的替诺福韦开始，更有效，它是由发生在分娩时降低病毒载量。婴儿易受感染，出生时，如果他们的母亲在他们的血液和体液中高水平HBV DNA的高风险。
平均来说，替诺福韦降低了妇女的病毒载量五倍。在中国的研究人员报告说，他们开始了24周，怀孕28之间的替诺福韦管理。其他最近的研究表明，治疗孕妇甚至更早在其怀孕是安全和有效地降低病毒载量。
所有新生儿进行免疫接种，并获得HBIG乙肝抗体，出生时，以防止感染。当出生12个月后进行测试，没有发现被感染。
来源：www.firstwordpharma.com/node/1279605
＃axzz3bC1YUS2C
研究人员发现为什么儿童成为慢性感染
研究人员可能终于发现了为什么新生儿和年幼的孩子很容易发展为慢性乙肝感染，而简短的（急性），感染后通常成人清除病毒迅速。
英国研究人员报告说，乙肝病毒潜入肝脏和幼儿期感染细胞，因为特殊的抑制性细胞，旨在保护青少年的肝脏炎症对抗基本上关停的免疫细胞，让他们攻击和煽动的HBV感染的肝。
多年来，研究人员一直试图理解为什么一个年轻的免疫系统无法攻击的HBV感染的肝脏。因为免疫系统从来没有回应，乙肝病毒能在肝脏中迅速繁殖。这被称为乙肝的“免疫耐受”的阶段
研究者们在5月的Nature杂志，表明抑制细胞在肝脏关掉免疫细胞通常会攻击感染，以此来防止炎症和损伤肝脏年轻人。
“如果我们能增强免疫系统，并抵消肝脏的抑制作用，那么感染可能被清除后大'爆'免疫活动，”研究人员建议，“这可能会导致短期的肝脏损害，但会防止疤痕和肝癌，我们在慢性（乙肝）的患者看到的长期损害。“
在他们的研究中，研究人员比较了乙肝患者及健康受试者血液和肝脏组织样本。他们发现患者感染的免疫耐受期有高水平的中粒肝脏髓源抑制细胞（gMDSCs）的。这些细胞通过切断他们的食物供给抑制免疫系统的战机T细胞。
的抑制性细胞制服两个T细胞通常会针对HBV感染的肝细胞以及T细胞引起的炎症，因为它们消除了感染的肝细胞。在研究中女性往往有较高水平的gMDSCs。
来源：www.nature.com/nm/journal/vaop/ncurrent/full/
nm.3856.html
专家建议治疗肝硬化精神错乱
有些肝硬化患者发展混乱，记忆力差，睡眠问题，有麻烦驾驶，因为他们的肝脏受损无法筛选的损害大脑的功能从他们血液中的毒素。
肝炎专家罗伯特博士吉什，写在网上日记Scribd，建议彻底的精神和身体检查以确诊这种痛苦，被称为肝性脑病。
饮食：吉什博士建议饮食有充足的蛋白质，以避免肌肉质量损失。
锌水平也应测量，因为低锌恶化脑病症状。患者锌缺陷应该采取每天50至200毫克之间。
治疗：脑病处理与抗生素丸利福昔明（Xifaxan）剂量为550毫克，每天。这种抗生素最初是为腹泻。灭滴灵（甲硝唑）是另一种抗生素，有助于患者的脑病。
益生菌：同时建议是益生菌补充剂，这有助于重新填充与自然菌的肠道，以帮助它消化食物和较低的合成氨生产。最近的一项研究发现，益生菌单独（无抗生素）为有效预防脑病160肝硬化患者发展过一段九个月。
益生菌，胶囊，通过提高产量的降低合成氨生产某些微生物的工作。研究发现，两倍多的未经治疗的患者开发性脑病比没有服用益生菌补充剂的患者。
不要把理学Fradin，真接收（新霉素）：另一种抗生素，新霉素，也改变了化学和细菌在肠道内氨低的水平，但它不应该被用来，基希博士建议。 “如果这种药物的处方为半年以上，听力测试应进行，因为可能有听力损失的风险。听力测试是关键，如果患者是使用速尿（呋塞米）与新霉素，”他写道。
来源：www.scribd.com/doc/265482027/
肝脑病
增加抗病毒药物后生存肝癌治疗
起始谁已经对抗病毒药物除去肝脏肿瘤乙型肝炎患者增加了它们的生存，尤其是当患者的治疗肝癌的早期阶段，根据刊登在中国癌症的报告。
研究人员随后224肝癌患者谁了肝肿瘤化疗栓塞使用成功删除。此方法直接喷射化疗成肿瘤，其通过阻断其血液供应饿死它。
大约一半的患者具有抗病毒，而另一半，对照组处理的，则没有。总体而言，与抗病毒药物治疗组手术后16个月存活，相比于中未经治疗的患者9.6个月的生存率。
但是，生存在抗病毒治疗的患者谁在肝癌的早期阶段显着增加。这些谁已经删除，而在早期阶段存活了另一个62个月与抗病毒药物的帮助下，相比26.2个月的生存率为未经治疗，早期肿瘤患者。
在肝癌患者的晚期阶段，抗病毒药物并没有延长生存期。
来源：http://7thspace.com/headlines/508704/
口服抗肝炎治疗b的生存影响
对肝癌患者初治
与chemoembolization.html
HBV糖尿病患者有较高的风险肝癌
来自台湾的一项新的研究发现乙肝病人谁有糖尿病或谁是他们的感染期间患上糖尿病正处于肝癌的风险较高。
根据该报告，发表在5月发行的杂志消化道药理学和治疗学，研究人员比较了肝癌率在2099乙肝患者谁曾反对2,080乙肝患者新发糖尿病的诊断没有患糖尿病。
糖尿病患者比例较高的开发肝癌（3.29％），与非糖尿病患者（2.02％）相比，研究人员报告。患者近期糖尿病的诊断也有肝癌稍高利率。
糖尿病患者往往有其他健康问题，包括肝硬化和肥胖。
由于乙肝糖尿病患者处于癌症的风险较高，医生应竭尽所能，以防止糖尿病的发展在这些患者中，和/或仔细监视谁开发糖尿病，而在他们的照顾，研究人员得出结论的患者。
来源：www.healio.com/hepatology/oncology/news
/在线/％7B6d308de1-614c-4423-b586-20f01a0e73e6％7D
/糖尿病增加风险换HCC-的大人，与乙肝病毒
长期使用抗病毒药物增加髋部骨折发生率略
要找出如果长期抗病毒治疗是安全的，香港的研究人员比较了46454未经乙肝患者对谁进行抗病毒药物治疗了五年4046例患者的健康，看是否长期治疗引起的骨质流失或肾脏问题。
综合研究，发表在五月号的中华肝脏病杂志，看了肾脏疾病和失败和髋部，脊柱和其他骨骨折的参与者。
研究人员指出略有增加治疗的乙肝患者中髋部骨折，但没有其他的骨折。
他们得出结论认为，抗病毒治疗，“...不增加总体肾（肾）和骨事件的风险。（抗病毒药）可能会增加髋部骨折的风险，但整体事件发生率较低。”
来源：www.ncbi.nlm.nih.gov/pubmed/25973979
第二系列疫苗可能对儿童所需腹腔疾病
患有乳糜泻，无法消化，根据在儿科传染病欧洲社会的第33届年会上发表的一项研究面筋可能需要heptitis乙肝疫苗助推器。
研究人员监测的72小儿重症过敏谁收到足三剂疫苗，以面筋，但谁仍然有低于推荐10 MUI /毫升，这是需要以防止感染乙肝抗体。
研究人员给予额外剂量疫苗的儿童和测量它们的抗体以后六个月。约85％谁收到的助力器的孩子取得的抗体的保护水平，但其余的15％是“无反应者”。
研究人员建议给予第二轮三个注射疫苗的腹腔疾病所有的孩子谁不首轮免疫投篮作出回应。
来源：www.firstwordpharma.com/node/1284715
＃axzz3bC1YUS2C
科学家发现HBV B系在古巴没有来自非洲
因为乙肝病毒毒株或基因型发展了几千年，在世界特定区域，他们在新的位置存在可以告诉人类迁徙的故事。
例如，目前在西非HBV基因型E是占主导地位的乙肝应变。因此，科学家们希望能够找到在非洲人解决加勒比岛屿谁是跨大西洋奴隶贸易中被带到那里HBV基因型Ë。
但有两个研究，一个在海地和最近的一次在古巴，既没有发现谁患有慢性乙型肝炎非洲奴隶的后代中HBV基因型Ë
在5月发行的医学杂志PLOSS之一，研究人员调查了172名古巴人的HBV基因型。与其寻找HBV基因型E，它们有望发现，他们发现，而不是占主导地位的HBV基因型为A，它起源于亚洲和欧洲。
这一发现是类似于研究在海地还发现了一个缺失基因型E.这意味着，HBV基因型E获得大概介绍到西非和18世纪19世纪的奴隶贸易后，停了下来。同样，HBV基因型A的大概介绍古巴奴隶贸易结束后。
来源：www.bioportfolio.com/resources/pmarticle/1239701
/Genetic-Diversity-of-the-Hepatitis-B-Virus-Strains-in-Cuba-Absence-of.html
作者: 君看一叶舟 时间: 2015-6-4 17:54
太丰富了，谢谢楼主，第二篇提到韩国研究者发现，无论病毒载量高低，抗病毒可以降低肝癌的发生率。这和我国国内研究者提倡的慢性HBV应积极抗病毒思想完全一致。
作者: 君看一叶舟 时间: 2015-6-4 18:02
第三篇提到了替诺停药的那组21人随后甚至其中2人表面抗原消失，而继续服用替诺的那一组却表面抗原没有下降？真是不可思议
作者: zgct 时间: 2015-6-4 19:25
好文
作者: 君看一叶舟 时间: 2015-6-4 21:47
肝癌经治疗后抗病毒提高生存率 第六篇
作者: 君看一叶舟 时间: 2015-6-4 21:52
第5篇:：肝硬化肝性脑病的诊断，饮食，与药物治疗。
作者: 君看一叶舟 时间: 2015-6-4 21:57
肝炎合并糖尿病更容易致癌
作者: 君看一叶舟 时间: 2015-6-4 22:11
对患有乳靡泻儿童应进行第二轮三次乙肝疫苗注射，产生足够应有抗体（正常是一轮三次）
作者: 君看一叶舟 时间: 2015-6-4 22:16
本帖最后由 君看一叶舟 于 2015-6-4 22:33 编辑
最后一篇搞笑，可以用不同乙肝病毒的类型来研究人类迁移，如黑人的迁移
作者: zgct 时间: 2015-6-4 22:19
君看一叶舟 发表于 2015-6-4 22:16 
最后一篇搞笑，可以用病同乙肝病毒的类型来研究人类迁移，如黑人的迁移
外文点评
作者: 42年才知道 时间: 2015-6-4 23:22
第二篇比较有实际意义，早期肝硬化，病毒阴，ALT正常，一样有2.2%的几率患癌。
作者: bigben446 时间: 2015-6-5 08:10
君看一叶舟 发表于 2015-6-4 22:16
最后一篇搞笑，可以用不同乙肝病毒的类型来研究人类迁移，如黑人的迁移
广义上的乙肝病毒在恐龙时代就有了
作者: zgct 时间: 2015-6-5 12:36
本帖最后由 zgct 于 2015-6-5 12:38 编辑
42年才知道 发表于 2015-6-4 23:22
第二篇比较有实际意义，早期肝硬化，病毒阴，ALT正常，一样有2.2%的几率患癌。 ...
这点恐怖，这点问题很大，据说估计中国有一亿乙人，中多玩3000万人发病，其中可能1000万，40岁左右基本迈入早期肝硬化，即使吃药，DNA阴性，ALT正常，也有每年2.2%患ca，最少约30万人有。。。。，攻克了！！。。。好药在哪里？？？？？？加快好药研发！
作者: 天行健君 时间: 2015-6-5 19:12
没人注意到这个？
Researchers Discover Why Children Become Chronically Infected
Researchers may finally have discovered why newborns and young children are prone to developing chronic hepatitis B infections, while adults usually clear the virus quickly after a brief (acute) infection.
研究人员可能已经发现新生儿和幼儿为什么会成为慢性感染，这个发现会为新药提供新的靶的吧，个人感觉这个发现和乙肝受体NTCP的发现重要性不相上下。
把慢性感染转化为急性感染就能靠人体本身治愈乙肝。
有没有高手深入解读一下
作者: newchinabok 时间: 2015-6-5 19:17
盼新药
| 欢迎光临 肝胆相照论坛 (http://hbvhbv.info/forum/) |
Powered by Discuz! X1.5 |